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BOOKS 



ANNAM.GALBRAITH,M.D, 



Four Epochs of Woman's Life 
i2mo of 260 pages. 

3d Edition, Ready Soon 






Personal Hygiene and Physical 
Training for Women 

i2mo of 393 pages, illustrated 
2d Edition 



PERSONAL HYGIENE 



AND 



PHYSICAL TRAINING 
FOR WOMEN 



BY 

ANNA M. GALBRAITH, M.D. 

M 

Author of " Hygiene and Physical Culture for Women " and " The Four 
Epochs of Woman's Life ; " Member of the New York County and State and 
the American Medical Associations ; Fellow of the New York Academy of 
Medicine ; Ex- President of the Alumnae Association, Woman's Medical College 
of Pennsylvania ; former Attending Physician, Neurological Department, of 
the New York Orthopcedic Hospital and Dispensary; late Attendiug Physician 
and Instructor in Diagnosis and Clinical Medicine at the Woman's Medical 
College, New York Infirmary 



SECOND EDITION, THOROUGHLY REVISED 



PHILADELPHIA AND LONDON 

W, B. SAUNDERS COMPANY 

1916 



.G-3 



Copyright, 1911, by W. B. Saunders Company. Reprinted 

April 1913, and October, 1915. Revised, 

reprinted, and recopyrighted 

November, 1916 



Copyright, 1916, byW. B. Saunders Company 






'; 



JAN 13 1917 



PRINTED IN AMERICA 



PRESS OF 

W. B. SAUNDERS COMPANY 

PHILADELPHIA 



CI.A453822 



In Loving Memory 

of 

HELEN WORTHING WEBSTER, M. D. 

Professor of Physiology and Hygiene and Resident Physician at Vassar College 
from 1874 to 1881 

An untiring worker of charming and inspiring personality 
the living embodiment of all that was womanly, 
great hearted, and noble 
This book is affectionately dedicated as a slight tribute of 
the esteem in which she was held, and in grateful acknowl- 
edgment of the value of her teachings 
By her former pupil 
THE AUTHOR 



PREFACE TO THE SECOND EDITION 



Since the writing of this book six years ago the entire 
subject of digestion has been revised by scientific research, 
and thanks to the same scientists the nutritive value of 
the various food-stuffs has been ascertained. The im- 
portance of this knowledge is so great that educators 
are now making an endeavor to have the nutritive value 
of artificial and canned goods placed on their labels; and 
the New York Board of Health has requested a large 
Chain of Restaurants to have the nutritive value of 
foods printed, beside the cost of the various articles, on 
their bill of fare. 

Hence the entire chapter on Digestion and Nutrition 
has been rewritten. In Chapter I has been given the 
result of original statistical studies, showing the urgent 
need for every woman to know and put into practice the 
principles of personal hygiene. 

Dancing has become such a popular form of exercise 
that a description of the plates giving the dancing steps 
has been added, together with some simple dancing ex- 
ercises. For these excellent descriptions the author^ is 
indebted to Miss Barbara Blankenhorn, a widely known 
teacher of music and dancing of Englewood, New Jersey. 

The reason that such a comparatively short space was 
given in this work to " pelvic physiology and hygiene" 
was that this subject had been treated in extenso, in 
"The Four Epochs of Woman's Life." 

Anna M. Galbraith. 

New York City, 
November, 1916. 

3 



PREFACE 



The aim of this work has been to present in a clear 
and concise manner the fundamental physiological laws 
on which all personal hygiene is based ; together with the 
practical, detailed directions for the proper development 
of the body and the training of the physical powers to 
their highest degree of efficiency by means of fresh air, 
tonic baths, proper food and clothing, gymnastic and out- 
door exercise, so that the tissues will be placed in the 
best possible condition to resist disease. 

The spirit of the times demands nothing less than the 
most perfect development of body and mind of which 
youth is capable, and maintaining the highest degree of 
efficiency of the adult worker for the longest possible term 
of years. The fiat has gone forth from the American 
Medical Association for the scientific education of the 
public in the laws of hygiene and sanitation. And the 
great civic movement inaugurated by that same Associa- 
tion and the Committee of One Hundred on National 
Health for the establishment of a' National Department 
of Public Health, promises to be crowned with success in 
the near future. And so it has been deemed superfluous 
to expound at length what preventive medicine has al- 
ready accomplished in the short space of fifty years by 
the eradication of terrible epidemics and many diseases, 

5 



6 PREFACE 

and what a general knowledge of applied hygiene might 
reasonably be expected to accomplish in the near future. 
It gives the author great pleasure to have this oppor- 
tunity of expressing her deep indebtedness to Miss Ruth 
Blankenhorn, Vassar College, A. B., 1909, of Englewood, 
N. J., a most artistic and graceful dancer who posed for 
all the illustrations; and to Miss Harriet I. Ballintine, the 
able director of the Vassar College Gymnasium, who ar- 
ranged the poses for the very excellent plates illustrating 
the free exercises and classic dances. Also to the Vassar 
College Athletic Association for 1908-09 for the especially 
arranged dances and field sports which they were so ex- 
tremely kind as to demonstrate for her benefit. 

Anna M. Galbraith. 
New York City. 



CONTENTS 



CHAPTER I 



The Wisdom of Physical Efficiency 11 

Physical Efficiency as an Exact Science; Marks for Phys- 
ical Efficiency; Statistical Study of the Physical Examina- 
tions of 160 Young Women; the Physical Status of the 
Women of Today; the Reflex Action of the Various Impair- 
ments of the Entire Organism. 

CHAPTER II 
Hydrotherapy 23 

Description of the Skin; Functions of the Skin; the Phys- 
iologic Effects of Water, Hot and Cold; the Chief Varieties 
of Baths; Ablutions; the Tub Bath; the Alcohol Rub; the 
Cold Dip; Alkaline and Saline Baths; the Rain Douche or 
Shower Bath; the Hot Foot-bath; the Site Bath; Salt Ablu- 
tion; the Turkish Bath; the Electric-light Bath; Indica- 
tions for the Use of Turkish Bath, and Contraindications; 
the Douche; Rationale of the Douche; Contraindications. 

The Internal Use of Water; Its Action on the Heart and 
Blood, on the Digestion; Therapeutic Indications for the 
Use of Water; Contraindications for Drinking Cold Water. 

Enemas; Vaginal Douche; Douching the Ear. 

CHAPTER III 

The Care of the Skin and Its Appendages 57 

The Complexion; the Action of the Bath in Health; the 
Proper Time to Bathe; the Care of Wash-cloths; Cleansing 
the Face; Protection of the Face; the Use of So-called Cos- 
metics for the Face; Facial Blemishes, Freckles, Liver Spots, 
Sallow Complexion, Pimples, Acne, Eczema, Wrinkles and 
Their Treatment; the Relation of Diseases of the Skin to 
Internal Disorders. 

The Hair; Dandruff; Causes and Treatment of Premature 
Thinness of the Hair and Baldness; the Care of the Hair; 
Gray Hair. 

The Cosmetic Care and Treatment of the Hands; Cos- 
metic of the Nails; the Care of the Feet; Painful Affections 
of the Feet. 



5 CONTENTS 

CHAPTER IV 

PAGE) 

The Digestive System: General Principles in Human 

Nutrition and Dietetics 80 

The Digestive Tract; Care of the Mouth and Teeth; 
Controlling Factors of Digestion; Psychic Aspect of Diges- 
tion; Importance of Mechanical Factors; Chemical Changes 
of Food in the Stomach; Intestinal Digestion; Metabolism; 
Constipation and Its Treatment. 

The Amount of Food Required; the Classification of 
Foods; Standard Dietaries; Maintenance Diet; Relations 
of Diet to Various Conditions of Life; Practical Facts for 
Guidance; Dietary in the Tropics; Food Economics; Table 
of Food Values. 

The Physiologic Action of Moderate Doses of Alcohol; 
the Effect of Alcohol on the Muscular System; the Effect of 
Alcohol on the Nervous System. 

CHAPTER V 

The Respiratory and Circulatory Systems: the Kidneys. . 137 
The Mechanics of Circulation and Respiration; the Cir- 
culatory Apparatus; the Lungs; Hygiene of the Lungs 
and Its Relation to the General Health; Relation of Res- 
piration to Body Heat; the Respiratory Functions of the 
Abdominal Muscles; the Importance of Good Chest Devel- 
opment, Proper Relation Between the Height, Weight, and 
Chest Measurements; Chemical Properties of Air; Town 
and Country Air; Dust and Its Relations to Disease; Role 
Played by Bacteria; Ventilation; the Injurious Effects of 
Overheated Air; the Proper Degree of Moisture for the 
Air of the House; Ventilation of Bed-rooms. 

Care of the Nose, Throat, and Ears; Impediments to 
Respiration; Ventilation of the Lungs and Breathing Ex- 
ercises; Cure of Chronic Bronchitis by Deep Breathing Ex- 
ercises; Relation of Colds to Pneumonia and Tuberculosis, 
and Their Prevention. 

The Kidneys and Their Functions; the Physiology of 
the Female Pelvic Organs. 

CHAPTER VI 

The Nervous System as the Balance of Power in the 

Body 184 

The Brain the Master Organ of the Body; the Functions 
of the Brain; Habit and Automatism; the Physiology of the 
Brain and Nervous System; the Hygiene of Work; the Tox- 
ins of Fatigue; Overwork; Signs of Overwork; Nature's Res- 
toratives; Avocation; the Physiologic Necessity for Laugh- 
ter; Vacations and Health; Sleep; Insomnia. 

The Eyes; Eye-strain; Description of the Visual Appa- 
ratus; Optical Defects and Their Correction; the Mechan- 



CONTENTS 9 

PAGE 

ism of Eye-strain; Locai Symptoms of Eye-strain; Arti- 
ficial Lighting; Hygienic Precautions in Reading and Sew- 
ing; Injuries to the Eyes; Symptoms and Treatment of 
Conjunctivitis; Trachoma; Styes. 

Functional Nervous Disorders; Headache; Neurasthenia. 



CHAPTER VII 

The Hygiene of the Mind and Its Relation to the Physical 
Health 224 

Heredity; Temperament; Social Instincts; Fear. 

Mental Development; Self-control, the Moral Sense, the 
Religious Instincts; the Advantages of College Life; Bal- 
ance of the Mental Faculties; the Effects of the Higher Ed- 
ucation of Women. 

The Environment; the Choice of Friends; Literature. 

The Power of the Will or Inhibition; the Effect of the 
Mental Attitude on the Physical Health; A Definite Occu- 
pation a Physical Necessity; the Psychology of Success. 

CHAPTER VIII 

Dress the Fundamental Cause of Woman's Physical 

Deterioration 252 

The History of Woman's Dress; the Corset in History; 
the Crusade Against the Corset; the Influence of the Corset 
on the Female Body; the Curved Front Corset; the Relation 
of Corsets to Abdominal and Pelvic Disorders; the Effects 
of Corsets on the Muscles; the Straight Front Corset; the 
Abdominal Corset; the Wearing of Corsets by Young Girls; 
What Style of Corset is the Least Injurious; the Shoe; the 
Stockings; the Essential Qualities for Winter Underclothing; 
the Length of the Walking Skirt; the Winter Street Dress. 

CHAPTER IX 

Physical Training the Key to Health and Beauty 283 

The Ancient Greeks the Most Perfect Type of Beauty; 
the Cause of the Inferior Physique of American Women; the 
Physical Training of the Japanese Women; Improved 
Physique as the Result of Physical Training; Increasing 
Stature and Improved Physique of American Men; Report 
of the Royal Commission of Great Britain on Physical 
Training; Physical Training Among the Ancients; the 
Influence of Physical Training on the Health and Life of 
the Individual; the Effect of Exercise on Brain Develop- 
ment and Character; the Physiology and Pathology of 
Exercise; the Relative Proportions of a Perfect Female 
Form; Table of Standard Weights for Women; the Muscu- 
lar System; the Benefits of Exercise; Passive Exercise; Mas- 
sage; the Balance and Carriage of the Body; Common 



10 CONTENTS 

PAGE 

Physical Training the Key to Health and Beauty {Con- 
tinued) 
Defects in the Carriage of the Body; the Heart's Need of 
Exercise; the Gymnasium in the Campaign Against Dis- 
ease; Gymnastic versus Athletic Training; Exercise After 
Eating; Effect of Brain Fatigue on Body Fatigue, and 
vice versa; Marks for Physical Efficiency; Advantages 
Derived from Athletic Sports; Ethical Value of Sports for 
Women; Forms of Athletic Games Best Suited to Women. 

CHAPTER X 

Symmetric Development: Good Carriage and Grace of 
Motion Through Gymnastics and Athletics 323 

Gymnasiums, Baths, and Athletic Associations: A Fun- 
damental Part of a Woman's College and a Model Woman's 
Club; the Vassar College Gymnasium; the Standardized 
Percentage Table for Physical Efficiency; Special Medical 
Blank for Women; Self-made Good Physique through 
Physical Training; Rules for Taking Exercise; Gymnastic 
Dress; the Configuration of the Foot; Correct Attitude in 
Standing. 

Corrective Exercises: Exercises for Developing the 
Various Regions of the Body; Shoulder-blade Exercises; 
Respiratory Exercises; Exercise for Forward Projection of 
Chest and Retraction of Abdomen; Shoulder and Back 
Exercises; Leg Exercises; Squatting Exercises for Muscles 
of Spine and Abdomen; Alternate Kneeling; Abdominal 
Exercises; Balancing Exercises for Poise and Carriage; 
Balancing Exercises for Extending Depth of Chest; Lateral 
Trunk and Waist Exercises; Exercises for Muscles of 
Back; Exercises for Muscles of Abdomen; Swimming Exer- 
cises for Back, Thighs, and Abdomen; Rope-pulling Exer- 
cises for Back, Chest, Waist, Legs, and Arms; Exercises in 
Trunk Flexions for Back, Abdomen, and Legs; Exercises 
with Chest Weights for Chest, Shoulders, and Arms; Box- 
ing and Fencing; Classic and ^Esthetic Dancing an Essen- 
tial Feature in Physical Training; Figures of the Dance with 
Some Simple Exercises. 

Outdoor Exercises: Effect of Walking on the Heart and 
Lungs; Running; Mountain Climbing; Swimming; Horse- 
back Riding as an Exercise; Rowing. 

Athletic Sports: Croquet; Lawn-tennis; Golf; Hockey; 
Basket-ball. 



Index 375 



PERSONAL HYGIENE 

AND 

PHYSICAL TRAINING FOR WOMEN 



CHAPTER I 

THE WISDOM OF PHYSICAL EFFICIENCY 

Physical Efficiency as an Exact Science; Marks for Physical 
Efficiency; Statistical Study of the Physical Examinations of 160 
Young Women; the Physical Status of the Women of Today; the 
Reflex Action of the Various Impairments of the Entire Organism. 

"Circumstances," said Napoleon, "I make circumstances." 

Physical efficiency stands for initiative, endurance, 
success; it is the very keynote of modern life and has 
become one of the burning questions of the day. West 
Point and Annapolis have always recognized this, and in 
order that their graduates should measure up to the high- 
est standard of efficiency a most rigid physical examina- 
tion was and is demanded as a prerequisite for admission; 
and during the whole of the four years' course physical 
training is systematically carried on so as to insure the 
most perfect physique possible, with the result that in 
addition to their great powers of endurance and initiative, 
is their distinguished carriage and elegance of bearing. 

To increase the safety of their passengers the railroad 
companies were the next to demand these same physical 
examinations to determine the efficiency of their applicants 
and employees. Other large corporations followed. 

So long as women remained in the home, or were willing 

11 



12 PERSONAL HYGIENE FOR WOMEN 

and content to accept any small wage that was doled out 
to them, the public did not seem especially interested in 
their physical condition. But when women, as a large 
teaching body or in any other public service, began to 
demand equal pay for equal work, the situation was 
materially altered, and in 1914 the English Royal Com- 
mission summed up the following conclusions: "Where the 
character and conditions of work performed by women 
approach those of the work of men, the pay of the women 
should approximate that of the men, but in so far as the 
efficiency of men is higher, the salaries of men should re- 
main higher." This at once changed the complexion of 
the matter, and physical efficiency for women became a 
matter of paramount and equal importance to both em- 
ployer and employee. 

Again, from the standpoint of social science, the physical 
efficiency of women is demanded because they are the 
mothers of the race, and on them, equally with the fathers, 
does the welfare of future generations depend, since it is 
believed that a child inherits equally from its parents — 
one-fourth from father and mother each, one-fourth from 
its grandparents, etc. The states are beginning to se- 
riously take up the framing of laws for eugenic marriages, 
based on fixed standards of physical efficiency of the con- 
tracting parties. And the day is not far distant when 
women as well as men will have to undergo physical ex- 
aminations to secure or hold any positions of importance. 

Then, too, one of the results of the present terrible 
European war has been to demonstrate that women pos- 
sess a large amount of latent powers and endurance which 
only needed for their development the same general 
physical training that the state gives her sons. Women 
are now being employed in these countries in all branches 
of the civil service, as well as in agriculture and the making 
of munitions, engaging in a vast number of employments 
and trades hitherto considered unfit for women, because of 
the great physical strength and endurance which they de- 
manded. 



THE WISDOM OF PHYSICAL EFFICIENCY 13 

Physical Efficiency as an Exact Science. — Physical 
efficiency is growing to be an exact science; it is demon- 
strable in figures. We have standardized percentage 
tables for measuring the capacity of the lungs, the strength 
of the heart and muscles, and, added to these, must be a 
normal condition of the digestion, kidneys, generative 
organs, sight, and hearing. If the sum total of these 
amounted to 100 per cent., that would mean capacity for 
the greatest possible endurance under strain, and so the 
most effective worker; for there is a direct relation be- 
tween the percentage standard of physical efficiency and 
the output of work, both as to quantity and quality. 

Marks for Physical Efficiency. — Sir Francis Galton, the 
great English scientist, was the first to conceive the idea 
of assigning marks for physical qualifications. They were 
as follows: Breathing capacity, strength tests, both to be 
regarded with reference to the height and weight; quick- 
ness of response to a signal, made either to the eye or ear; 
the sense of sight and hearing, and the color sense. 

Realizing the usefulness of these tests in measuring the 
physical efficiency, Professor Sargent included them in the 
physical examinations of the Harvard students. The 
strength tests consist of that for each forearm, of the back 
and legs, the dip, the pull-up, and the lung capacity. The 
combination of these seven tests is what is known as the 
intercollegiate strength test, and is the best means as yet 
devised for measuring the general muscular strength and 
the respiratory power. 

It is obvious that many of these tests would be needed 
only by men going into the army or navy, or qualifying for 
civil engineers or professional athletes, etc. So it was con- 
sidered best to modify these tests to meet the require- 
ments of physical efficiency for women. 

For the large number of measurements of the arms, legs, 
etc., included in the Sargent system have been substituted 
the rating of the condition of the heart and circulatory sj^s- 
tem, including the blood-pressure; lung and chest develop- 
ment; digestive and nervous system; the kidneys and gen- 



14 PERSONAL HYGIENE FOR WOMEN 

erative organs; the muscular system; tests of endurance; 
ocular and aural tests; with a final impression of the 
working efficiency. 

This standardized percentage table for physical efficiency 
of women was worked out and the ratings made with the 
able assistance of Dr. David Bovaird, Associate Professor 
of Clinical Medicine, Columbia University, and Dr. George 
A. Meylan, Associate Professor of Physical Education, 
Columbia University; and it has seemed to us that this 
combination of tests is of greater practical value, since the 
maintenance of physical efficiency depends upon the in- 
tegrity of all of the organs of the body. These ratings were 
made to cover the Special Medical Blank for Women, 1 
gotten up for the examination of the women candidates of 
the Presbyterian Board of Foreign Missions. 

For many years the various Boards of Foreign Missions, 
which are the great church corporations, have required 
that candidates for this work should pass a physical ex- 
amination similar to that demanded by the life insurance 
companies, and so similar blanks were sent out to be filled 
by the local examining physicians; but because of the 
many breakdowns of the women on the field, and the great 
detriment to the work and the expense thus entailed, four 
years ago the Presbyterian Board of Foreign Missions de- 
cided to have all of their women candidates re-examined 
in New York by a woman physician especially appointed 
by them for this purpose. 

The results of these examinations have been most il- 
luminating as to the physical condition of women who call 
themselves well, to say nothing of what the medical pro- 
fession in general seem to consider as standards of good 
health in women who will be obliged to do very hard 
work under most trying climatic conditions, which all 
Life Insurance Companies rate as extrahazardous. 

The composite picture thus obtained by the statistical 
study of the physical examinations of these 160 young 
women is of great value, not only because it is the first of 
1 See page 330. 



THE WISDOM OF PHYSICAL EFFICIENCY 15 

the kind made for the first decade after leaving college; 
but also because it is very fairly representative of the aver- 
age physical condition of the great masses of women who 
are engaged in teaching, social service, secretarial work, 
etc.; and, further, it demonstrates the striking difference 
in physique of women who call themselves well, and that 
of the normal standard of physical efficiency to which 
most of these women could have attained by proper phys- 
ical education. 

Statistical Study of the Physical Examinations of 160 
Candidates. — This study is made from the records of four 
successive classes of young women coming from all over 
the United States, city and country, including college and 
non-college graduates, whose occupations were physicians, 
teachers, students, nurses, social workers, housewives, etc. 
All had passed a preliminary physical examination. The 
average age was twenty-eight years, when woman should 
be physically at her best. 

/. Acute Diseases Since Childhood and Number of Days Lost Through 
Illness. For Classes of 1918 and 1914 Only, Consisting of 100 
Women. 1 

History negative — i. e., no history was given of any 

acute illness after the children's diseases 30 per cent. 

Acute illnesses, including operations 70 " " 

Previous year's record: 

Lost no days from illness 42 " " 

Operations performed, followed by complete cure ... 27 " " 

Marked loss of weight 23 " " 

Total loss of time from illness, including postopera- 
tive treatment, would equal entire time of one 
woman for 8| months. 

Of the acute illnesses, the following are of the greatest 
interest because now preventable: Typhoid fever, 12 per 
cent. ; malaria, 6 per cent. ; tonsillitis, 6 per cent. 

Of the causes for operations, appendicitis leads with 13 
per cent.; of these, 9 per cent, were simply for the removal 
of the appendix; 2 per cent, for the removal of the ap- 

1 Similar records for the classes of 1915 and 1916 were not pre- 
served. 



16 PERSONAL HYGIENE FOR WOMEN 

pendix and diseased right ovary; and 2 per cent, for the 
removal of the appendix and ovarian cyst. The recovery 
was not only complete from the operation, but the general 
health was greatly improved in every respect. 

Of the cases of tonsillitis, 4 per cent, were operated on 
not only with complete recovery, but also with the cure of 
rheumatism from which these women had previously 
suffered. 

//. Heart and Circulatory System. 

Examination of heart negative, with absence of mur- 
murs 97.5 per cent. 

Action of heart weak 54.0 " 

Pulse weak and rapid 50.0 " 

Subnormal blood-pressure 63.0 " 

Anemia present 55.O " 

Normal condition of veins 95.0 " 

Subnormal temperature 40.0 " 

Class average 7.5 " 

III. Lungs and Chest Development. 

Examination of lungs negative, with normal frequency 

and character of respiration 97.0 per cent. 

Subnormal chest girth in relation to height and weight, 

of 5J inches 87.0 " " 

Subnormal chest expansion of 1 inch 82.0 " " 

Subnormal lung capacity, measured by spirometer, 45 

cubic inches 75.0 " " 

Unhealthy condition of nose and throat (postnasal 

catarrh or enlarged tonsils) 20.0 " " 

Class average 7.5 " " 

IV. The Digestive System. 

Gastro-intestinal indigestion was present in 35.0 per cent. 

Hepatic congestion with tendency to bilious attacks . 20.0 " " 

Constipation 33.0 " " 

Catarrhal appendicitis (operation at once advised).. . 4.0 " " 
Class average 8.5 " " 

V. The Kidneys. 

Urinalysis negative in 96.0 per cent. 

Slight traces of albumin (with hyaline casts in 2 per 

cent.) 4.0 " " 

Floating kidney 0.8 " " 

Class average 9.6 " " 



THE WISDOM OF PHYSICAL EFFICIENCY 17 

VI. The Generative Organs and Menstrual Function. 

Pelvic organs normal 33.0 per cent. 

History, menstrual periods normal 38.5 " 

Displacements and inflammation, uterus . . 67.0 " 

Accompanied by falling and inflammation of ova- 
ries in 12.0 

Hemorrhoids 3.0 

Fibroid tumors 1.5 

Dermoid cyst 75 

Operations advised for retroflexed uterus and cur etage 1.5 " 

Dilatation and curetage 1.5 " 

Class average 7.5 

VII. The Nervous System. 

Subject to headache 33.0 per cent. 

Tendency to nervous exhaustion 11.0 " " 

Hysteric 3.0 » " 

Insomnia 7.0 

Mental poise good 75.0 

Class average 8.5 

VIII. The Muscular System. 

The average height 5 ft. 3| in. 

Normal weight # 126 pounds. 

Normal relation of weight to height and age 33.0 per cent. 

Averaged 17 pounds underweight 47 .-0 " " 

Posture good in sitting and standing 33.0 " " 

Posture bad, round shoulders, stooped position, mus- 
cles flabby. . 67.0 " " 

Strength tests taken only for class of 1915 (30 women) : 

Highest 802 points. 

Lowest 338 " 

Class average 570 " 

Class average estimated . . . . 7.2 per cent. 

IX. Tests of Endurance. 

Took systematic daily exercise, walking 3 miles 25 per cent. 

Took some exercise daily, 1 mile or under 50 " " 

Took absolutely no systematic daily exercise 25 " " 

Outdoor sports known, but not practised 10 " " 

Test walk of 3 miles not given. 

Heart reaction after exercise, hopping 100 feet, not given. 1 

X. General Impression of Working Efficiency. 
Class average 8.2 per cent. 

1 As the physical examinations are made during the time of the 
Annual Conference, in order to shorten the time as much as possible 
the Board requested that the tests of endurance be omitted. 

2 



18 PERSONAL HYGIENE FOR WOMEN 

General Summary. 

20 per cent, averaged from 67 to 75 per cent. 

25 " " " " 75 to 80 " " 

50 " " " " 80 to 85 " " 

5 " " - " " 90 to 95 " " 

Class average estimated, 80 per cent. 

Ocular Tests 

Where the vision was normal, or had been corrected by glasses, 
this was rated as normal; because of the occupations of these 
women it was practically so. 

The most striking points of weakness in the entire class 
were the bad postures in sitting and standing, consisting 
of round shoulders, a stooped position, and flabby muscles, 
67 per cent. ; a deficiency of one-seventh of the normal chest 
and lung development, accompanied by a deficiency of 
one-third of the normal chest expansion, 85 per cent.; 
weak hearts with weak and rapid pulse, subnormal blood- 
pressure, and anemia in over 50 per cent. ; over 66 per cent, 
had some form of pelvic trouble which was acting to under- 
mine the whole system. 

Aside from tuberculosis, life insurance companies re- 
ject applicants who fall more than 20 per cent, below the 
normal standard of weight, and because of this 16 per cent, 
would have been rejected. The cause of this great loss of 
weight was due to malnutrition and overwork, and had it 
seemed practicable to adhere to Professor Meylan's wise 
advice that anyone who fell below 7.5 per cent, in any 
one series of tests, or below 75 per cent, in the general 
average, 20 per cent, of the entire class would have been 
turned down. 

It* must be taken into consideration that these examina- 
tions were made during the first week of June, at the end of 
a hard year's work; but, making due allowance for this, the 
results of these examinations have revealed such a subnor- 
mal condition of the vital organs of the body as to be ap- 
palling even to those of us who have long been familiar 
with these subjects. In addition to this was the fact that 
many unsuspected ailments needing immediate attention 



THE WISDOM OF PHYSICAL EFFICIENCY 19 

by physicians or surgeons were discovered in a class of 
women who considered themselves well. 

The Physical Status of the Women of Today.— The 
strong presumption that the above statistics are very fairly 
representative for the average woman of today is strongly 
borne out by data furnished by the absence on account of 
illness of the teachers of New York, and by correspond- 
ing statistics recently published by the Life Extension 
Institute of New York City. 

Statistics compiled during the year 1913-14 showed that 
more than 20 per cent, of the teachers of the New York 
public schools were absent at some time on account of 
illness, and that these absentees averaged 16| school days. 
The data obtainable showed four prevalent ailments: 
diseases of the respiratory organs, 35 per cent.; acute 
contagious diseases, 16 per cent.; nervous diseases, 15 
per cent.; and digestive disorders, 11 per cent. And on 
the health of the teachers ultimately depends the efficiency 
of the entire educational system of the country. 

The Life Extension Institute of New York, in its tabula- 
tion of 2000 examinations of young men and women clerks 
between the ages of thirty and thirty-five years, showed only 
3 per cent, normal, i. e., free from bodily impairments and 
from habits of life which were leading to such impairments; 
and showed 59 per cent, sufficiently impaired to justify 
their recommendation to the definite care of their family 
physician. "These statistics were compiled at an age 
when the human being is supposed to be at the very prime 
of life. The results prove that the majority of young men 
and young women in New York City begin to die as soon 
as they are grown up. Deaths due to degenerative dis- 
eases have increased 86 per cent, in the past thirty years; 
this means an increased death-rate whereby between 
100,000 and 200,000 lives are lost every year." 

The Reflex Action of Some of These Various Impair- 
ments on the Entire Organism. — In the normal erect posi- 
tion of the body the trunk is given its greatest length, the 
head is held erect, the shoulders thrown back flat against 



20 PERSONAL HYGIENE FOR WOMEN 

the ribs, the chest is high, and the abdomen flat. (See 
Plate III, Senegalese woman.) 

In the bad postures noted in 67 per cent, of the entire 
class, of round shoulders with a stooped position and 
flabby muscles, we note four distinct and prominent fac- 
tors in the breaking down of the human organism: 

/.« The Effect on the Chest and Lung Development and 
on the Action of the Heart. — In this malposition the upper 
part of the body is inclined forward, with the result that the 
chest is flattened to the extent of 1 inch. The restriction 
which this must mean to the expansion of the lungs is 
evident; and when it is realized that in the erect position 
the heart occupies the space between the breast bone and 
the spine, with practically no space to spare, the resulting 
interference with the heart's action is evident. 

It is a very serious matter when we have superadded to 
a deficient chest development a deficient chest expansion. 
For these are the very women in whom because of their 
general run-down condition and undeveloped muscles 
the breathing is very superficial; the apices of the lungs, the 
favorite site of tuberculosis, and the deeper portions are 
seldom expanded; and not only does the body suffer from 
a deficient oxygen supply, but there is an equally defective 
suction power on the part of the heart, which means a poor 
circulation and a lowered general nutrition of the whole 
body. 

The main function in metabolism is oxidation, and 
scarcely a step in the series of chemical changes proceeding 
within the body is possible in the absence of an abundant 
supply of oxygen, constantly renewed. Living in close 
rooms lowers the vitality to an extent little dreamed of by 
most persons. 

II. The Effect on the Abdominal Viscera. — In the normal 
erect position the abdominal muscles remain taut and 
afford proper support and pressure to the abdominal vis- 
cera and the great splanchnic circulation of large blood- 
vessels; whereas in the stooped position the muscles of the 
abdomen, not being properly used, become weakened and 



THE WISDOM OF PHYSICAL EFFICIENCY 21 

sag forward, causing the downward displacement of all 
of the abdominal viscera, with consequent disturbance of 
their circulation and function. Many cases of indigestion, 
congestion of the liver, and constipation can be explained 
in this way. 

III. The Effect on the Circulation of the Spinal Cord. — 
The circulation of the spinal cord is very largely dependent 
on the tone of the muscles of the spine ; hence the weakness 
of these muscles interferes with its circulation. In the 
spinal cord are large nerve-centers which have to do with 
the control of the arms and legs as well as of the organs of 
the trunk, so that anything which lowers the tone of these 
centers depresses the vitality of the organs supplied by 
them; and this is believed to be the cause of many cases of 
so-called nervous indigestion. 

IV. The Waste of Energy which Results from Faulty 
Posture. — Weak foot, in its final stage flat-foot, is more 
common in women than in men because it is not purely 
a local condition in the arch of the foot, but primarily due 
to a weakened condition of the leg muscles that support 
the arch. Weak feet are gradually converted into flat- 
feet by faulty standing and walking and lack of leg exer- 
cises. 

Many cases of nervous prostration are to be traced not 
merely to overwork or worry, but to the waste of energy 
which results from the faulty posture of the body and 
with the interference of the circulation in the spinal cord, 
and the consequent weakness of the nerve power which 
results. In other words, it is not the load which breaks 
the bearer down, but the way in which the load is carried. 

Good chest and lung development, a strong heart, well- 
developed and firm muscles are the tripod on which rests 
physical endurance and resistance to disease. And this 
was just where the entire class was found to be gravely 
subnormal. 

Physical training consists primarily of heart training; in 
increasing the breathing capacity; in strengthening and 
developing the heart and other muscles of the body. As 



22 PERSONAL HYGIENE FOR WOMEN 

the muscles become stronger the body is held more erect, 
and this favors, as we have seen, all of its functions. 

And it is not generally understood how great is the 
effect of physical training on the brain and mental activ- 
ities. With a strong and vigorous action of the heart 
there is a feeling of courage and general exaltation; whereas 
with a weak heart and feeble circulation fear and impaired 
mental activity predominate. 

The charge is constantly laid at the door of women that 
they seldom rise above the mediocre, and have never been 
leaders in the world of art, literature, the drama, science, 
or the learned professions; that it is men who have invented 
devices for the home! 

According to statistics, of the 25,000,000 wage earners 
in the United States, 8,000,000 are women, of whom 
1,250,000 are over forty-five years of age and 637,000 
under fifteen years of age. From an economic point of 
view, anything which will raise the working efficiency of 
one-third of our producing population, whose average wage 
is now the paltry sum of $6 per week, must be welcomed, 
because it not only prevents loss of time from work, but 
also the cost of illness. The study of the above statistics 
demonstrates the fact that the physical efficiency of women 
can easily be doubled; that should mean that the average 
wage should be raised to $12 per week, which would be a 
vast economic gain to the individual, the home, and to the 
state. 



CHAPTER II 

HYDROTHERAPY 

Description of the Skin; Functions of the Skin; the Physiologic 
Effects of Water, Hot and Cold; the Chief Varieties of Baths; Ablu- 
tions; the Tub Bath; the Alcohol Rub; the Cold Dip; Alkaline and 
Saline Baths; the Rain Douche or Shower Bath; the Hot Foot-bath; 
the Sitz Bath; Salt Ablution; the Turkish Bath; the Electric-light 
Bath; Indications for the Use of Turkish Bath, and Contraindica- 
tions; the Douche; Rationale of the Douche; Contraindications. 

The Internal Use of Water; Its Action on the Heart and Blood, 
on the Digestion; Therapeutic Indications for the Use of Water; 
Contraindications for Drinking Cold Water. 

Enemas; Vaginal Douche; Douching the Ear. 

The term hydrotherapy will be used here in its broadest 
sense, and may be defined as the hygienic and systematic 
use of water, both externally and internally, for the preser- 
vation and restoration of health and the prevention of 



The hygienic and therapeutic value of the systematic 
use of water is just beginning to be appreciated by the 
medical profession. When this newly acquired knowledge 
is put to practical use by the great masses of the people, 
there will be a greatly diminished necessity for the use of 
drugs. Indeed, water has been pronounced by a high 
medical authority to be, and probably is, more nearly a 
panacea for all human ills than any other known agent. 

The bath is generally considered merely as a cleansing 
procedure, whereas this is only one of its beneficial effects. 
There is, in addition, the stimulation of all the functions 
and organs of the body obtained through the temperature 
of the water, and the mechanical stimulation which is 
obtained by the mode of application. 

Again, the skin is not a mere covering for the body, but 



24 



PERSONAL HYGIENE FOR WOMEN 



one of its most important organs, with well-defined func- 
tions ; so that, in order to obtain a clear understanding 
of the subject, it is necessary first to consider briefly the 
functions of the skin; and, secondly, the physiologic 
action of water. 

Description of the Skin. — The skin is a very sensitive 
and complex organ, and upon the condition of the skin 
and the vicissitudes to which it is exposed the health of 
the individual is dependent to a very great degree. 




Fig. 1. — Vertical section of skin: sbg, Sebaceous glands; ep, epider- 
mis; h, hair; d, derma (Fox). 

The skin is composed of three distinct layers— the 
epidermis, the corium or true skin, and the subcutaneous 
connective tissue. The appendages of the skin are the 
hair, nails, the sebaceous and sweat-glands. This com- 
plicated structure is supplied with blood-vessels, lym- 
phatics, and nerves. 

The Epidermis. — The outer layer of this is the horny 
layer; when a blister is formed, its fluid raises the entire 
epidermis from the true skin. The flat scales forming the 



HYDROTHERAPY 25 

horny layer are continually being thrown off; this process 
of desquamation is increased by the friction of the clothes, 
of bathing, massage, and so forth, and is as constantly 
being replaced by new cells from underneath. 

The corium, or true skin, is the most important part of 
the integument. This is a thick, felt-like tissue which is 
pierced in all directions for the passage of the blood-ves- 
sels, lymphatics, sweat-ducts, and nerves, and affords 
lodgment for the hair follicles and sebaceous glands. The 
tension of the skin is produced by its muscular structure 
and elastic network, and is subject to temperature changes. 
This power of contractility is known as the tone of the 
skin. 

The skin has two kinds of glands, the sebaceous and 
sweat-glands. The sebaceous glands consist of a gland 
structure, with a short excretory duct, which opens upon 
the epidermis or into the hair follicles. These glands 
secrete an oily substance, which keeps the hair and skin 
soft and protects them from the sweat. 

There exists in the sebaceous glands of the skin an 
infinite number of vulnerable points for infection, and the 
greater part of the process of cleanliness is directed toward 
their protection. If in any part of the skin there is an 
accumulation of bacilli, their toxins, or excretions, and, 
at the same point, a collection of sebum, the friction of the 
clothes, caused by the movements of the body, becomes 
an active agent in effecting their absorption by the skin. 
Hence, the scientific basis for the necessity of the daily 
bath. 

In the subcutaneous tissue we find the fat; it is this part 
of the skin that contributes to the roundness and beauty 
of the body. It is increased by abundant fatty food, 
sedentary habits, and freedom from care. 

Functions of the Skin.— The skin exercises three dis- 
tinct functions; first, as an organ of sense; second, as an 
organ of excretion; and third, as an organ of heat regula- 
tion. 



26 PERSONAL HYGIENE FOR WOMEN 

Next to sight, the sense of touch is the most important 
of all the senses. Through this sense the human organism 
is made conscious of its contact with the outer world. 
The cutaneous nerve-endings stand guard, as it were, over 
most of the functions of the human body. 

The importance of the action of the skin as an organ of 
excretion will be better understood from the well-known 
fact that the skin is one of the most important aids to the 
kidneys. That the perspiration and the urine are to a 
certain extent vicarious excretions has been proved. 

The blood is the circulating medium which not only 
serves to convey nutritive materials from the stomach to 
the tissues, and the excrementitious materials from the 
tissues to the excretory glands, but also to equalize the 
body temperature. It conveys the surplus heat from the 
interior of the body to the surface, where it may be dis- 
sipated by conduction, radiation, and evaporation. 
Nearly nine-tenths of the daily heat-loss takes place 
through the skin; and of this, one-seventh is due to 
evaporation, which is enormously increased by perspira- 
tion. 

The amount of perspiration produced daily is about 
two pints, or in the neighborhood of g-j of the body weight. 
This is double the amount of water thrown off by the 
lungs. The watery portions of the perspiration are readily 
evaporated, and the solid constituents are deposited upon 
the skin. Urea and uric acid, together with more subtle 
poisons, are found in the sweat. 

Animal Heat. — The heat of the body is wholly derived 
from foods, which, when completely oxidized within the 
body, produce practically the same amount of heat and 
energy that would be generated by their combustion out- 
side the body. 

But it is essential, in order to keep the body of warm- 
blooded animals at a constant or normal temperature, that 
an increase in the heat-production should be accom- 
panied by a corresponding increase in the heat dissipa- 
tion; the functions are reciprocal, and this equilibrium 



HYDROTHEEAPY 27 

is regulated and maintained by a special nervous and 
functional mechanism. 

The automatic protective measures against the effects 
of heat are : 

First. — Dilatation of the cutaneous vessels and an 
acceleration of the circulation through the skin and the 
subcutaneous tissue. By this means the dissipation of 
heat is increased; the sweat at the temperature of the 
blood, deposited upon the surface of the body, evaporates 
under favorable circumstances, and in this way consider- 
able amounts of heat are abstracted from the body. In 
consequence of sweating and its evaporation, the blood 
circulating through the skin is cooled, and returning to 
the internal organs at a lowered temperature, prevents 
their overheating. 

Second. — Should the action of heat be continued for a 
greater length of time, a large amount of blood will be 
retained in the skin in consequence of the loss of tonicity 
of the cutaneous vessels ; the cutaneous circulation will be 
slowed, and thereby the blood, heated at the surface of the 
body, is prevented from returning to the internal organs 
and so overheating them. 

Third. — In consequence of the accumulated amount 
of blood in the skin, a diminished amount of blood will 
remain in the internal organs; thus their activity, and 
thereby also the production of heat, will be lessened. 

In these processes will be found a safeguard against the 
excessively rapid penetration of heat to the internal 
organs, and against the unduly rapid elevation of the 
body temperature through thermic influences. 

As a result of the stimulating influence of cold, there 
first occurs contraction of the skin and its vessels. This, 
by restricting the dissipation of heat, brings about perfect 
compensation if the abstraction of heat be but slight; 
and but partial compensation, if the abstraction of heat 
is more marked. In the latter event the body tempera- 
ture will continue to decline, to a greater or less degree; 
in the former it will remain constant. 



28 PERSONAL HYGIENE FOR WOMEN 

The role played by the skin in maintenance of the nor- 
mal temperature of the body is indispensable. 

The normal temperature of the adult human body is 
98.6° F. in the mouth, and that of the rectum and vagina 
is one degree higher. 

Fasting, sleep, and short applications of heat all decrease 
heat-production; during sleep the temperature of the body 
falls half a degree or more. 

Respiration by the skin varies from J to 1 per cent, 
of the total amount of oxygen taken into the body, and a 
somewhat lower percentage of carbonic acid is thrown 
off through this channel. 

The skin absorbs substances in watery solutions with 
difficulty, on account of the oil lying upon and in the 
epidermis; substances dissolved in oil and rubbed in are 
more rapidly absorbed; absorption takes place rapidly after 
the skin has been washed with ether, chloroform, or alcohol. 

The Physiologic Effects of Water. — These depend 
on whether the water is taken internally or applied ex- 
ternally. If applied externally, the effects will depend 
upon the temperature, whether hot, tepid, or cold; 
also on the manner of application, but, , most of all, on 
the length of time which it is applied and the state of 
health of the individual. 

The temperature of water is classified as very cold, from 
32° to 55° F.; as cold, from 55° to 65° F.; cool, from 
65° to 80° F.; tepid, 80° to 92° F.; warm, 92° to 98° F.i 
hot, 98° to 104° F.; very hot, 104° F. and above. 

Heat. — A general hot bath produces dilatation of the 
vessels of the skin and contraction of the vessels of the 
brain; a general activity of the glands of the skin, both 
perspiratory and sebaceous. Perspiration may be pro- 
duced, either to the degree of slight moisture or of profuse 
sweating, according to the length of time and the intensity 
of the application made. In a very hot bath the rate of 
perspiration may be increased from fifty to sixty times 
the ordinary amount. The most pronounced effect pos- 
sible may be secured by either the electric light or sun bath. 



HYDROTHERAPY 29 

Loss of fluids from the body has a depressing effect 
similar to, though somewhat less marked than, that 
produced by bleeding, so that there is a vital necessity for 
administering water internally before, during, and after 
the bath. 

Prolonged and repeated perspirations induced by 
artificial means weaken the skin, and thus lessen its 
power to resist cold impressions, unless counteracted by 
frequent cold applications. 

The general and usual reactions following the applica- 
tions of heat are atonic and depressing in character. For 
the most part, the reactions following cold applications 
are to be preferred to those following hot ones. 

The three great vascular areas of the body are the mus- 
cles, the portal system, and the skin. Each of these 
parts may be regarded as a great reservoir, capable of 
retaining a large part of the entire amount of blood of 
the body. When one of these areas is in a state of con- 
gestion, the others must be in a comparative state of 
anemia. 

The restorative effects due to the application of heat 
are due partly to the elimination of fatigue poisons which 
is thereby encouraged, as well as by the reflex stimulation 
of the nerve-centers. The good effects are much more 
decided and lasting, and the exhausting effects neutralized, 
if the hot application is followed by a short cold one. 

The effects of a neutral bath, 92° to 95° F., is sedative, 
diminishing nervous irritability. 

A hot-water bottle or fomentations, placed over the 
stomach for an hour or two after eating, increase the 
gastric secretions, and, when placed over the liver, 
increase the flow of bile. 

The Physiologic Effects of Cold. — In suitable cases a 
short general application of cold is a powerful heart tonic. 
Cold causes a contraction of the vessels of the skin and 
of those of the brain, with a dilatation of the internal 
vessels. There are pallor and coldness of the skin, and 
an almost instantaneous suspension of perspiration, 



30 PERSONAL HYGIENE FOR WOMEN 

which is dangerous only when the body is in a state of 
fatigue. 

If the application of cold is long continued, the surface 
becomes blue, the temperature of the muscles beneath the 
skin is lowered, thus checking heat-production in these 
muscles; the circulation is slowed, and the heart's action 
is diminished in frequency. There is a gooseflesh appear- 
ance of the skin; a sensation of chilliness, trembling, 
shivering, chattering of the teeth; at first a quickening 
and then slowing of the pulse, and deep gasping respira- 
tion. 

When the cold application is considerably prolonged, 
the tendency to reaction is suppressed. There is an ex- 
haustion of the nerve-centers as well as of the heat- 
producing powers of the body. Thus, the system grad- 
ually loses its power to resist the depressing effects of 
cold. The repeated chillings of the body increase the 
length of time required to return to the normal tempera- 
ture. Applications of water below the temperature of 
the body always lower the temperature. 

Reaction. — If the application of cold is of very short 
duration, of very low temperature, and given under high 
pressure, the phenomena of reaction begin immediately 
on its cessation. 

The reaction consists in a dilatation of the surface 
capillaries, with contraction of the internal vessels; red- 
ness of the skin; the skin is smooth, soft, and supple; 
there is a sensation of warmth, comfort, and well-being; 
respiration is slower and deeper; there are a fall of the 
internal temperature and increase of perspiration. 

Certain measures to favor reaction should be taken 
before the bath, such as exposure to the air of a warm 
room, drinking hot water, and short exercise of a rather 
vigorous kind. 

During the bath the measures which favor reaction are 
short, sudden applications of cold, friction while in the 
bath with the hand, and pressure effects in the douche. 

After the bath reaction is favored by vigorous rubbing, 



HYDROTHERAPY 31 

a thorough drying of the body, warm clothing, warm air 
of the room, and as vigorous exercise as the strength of 
the individual will permit. 

Conditions which are unfavorable to healthy reaction 
are: old age, infancy, exhaustion, either temporary or 
from an excessive loss of sleep, or extreme nervous ex- 
haustion, obesity, rheumatic diathesis, unhealthy or 
inactive skin, profuse perspiration when accompanied 
by a state of fatigue, extreme nervous irritability, a very 
low temperature of the skin, an immediately preceding or 
impending chill, and extreme aversion to cold applications. 

The average temperature of the human nude skin is in 
the neighborhood of 90° F. The difference between the 
temperature of the skin and water is the chief element in 
determining the reaction of the individual. It is evident 
that water at a temperature of 90° F. would be neutral or 
indifferent; the difference of intensity of effect is in pro- 
portion to the difference of temperature of the water and 
skin. The duration of the cold procedure is an important 
element in the production of reaction. It may be laid 
down as a rule never to give any cold-water application 
without friction. The physical and psychic state of the 
individual exerts more or less influence upon his reactive 
capacity. An anemic, or otherwise depressed individual 
must be managed with great circumspection, because she 
bears heat abstraction badly. The hydriatic procedure 
must always be adapted to the reactive capacity of the 
bather. 

The woman must be thoroughly rubbed after the bath 
until a good reaction has occurred. Especial attention 
must be paid to the feet and legs. The bather should 
first be rubbed with a warm towel or sheet, and then with 
the bare hands of the attendant, as the warm hand greatly 
facilitates the reaction. The bather is by no means dry 
when the skin ceases to feel wet. So long as the skin is 
soft and spongy, it still contains moisture which has been 
absorbed by the superficial layers of the epidermis. The 
absorbed moisture, being left to evaporate after the bath, 



32 PERSONAL HYGIENE FOR WOMEN 

the individual is liable to become chilly and contract a cold, 
which is erroneously attributed to the bath itself. 

Other injurious effects following imperfect reaction 
after the cold bath are secondary chills or a continuous 
chill lasting for several hours. The hands and feet are 
cold, there is headache, not infrequently diarrhea, and 
other evidences of internal congestion, such as abdominal 
or ovarian pain, vertigo, etc. 

Reaction may be favored by covering the patient with 
blankets, surrounding her with hot-water bottles, and 
giving her hot tea to drink. Exercise should follow the 
bath. Walking for from twenty minutes to an hour is 
the most usual form of exercise. Very vigorous exercise 
for a short time cannot be substituted for moderate 
exercise for a longer time. 

The Tonic Effect of Cold Upon the System. — The effect 
of cold upon the muscles, when given in the form of a cold 
bath, douche, or spray, is to augment muscular energy 
and tone to a very great extent; this increased muscular 
tonicity is the cause of the slight shivering. The cold 
douche, if short, — one or two seconds, — and given with a 
pressure of from 25 to 30 pounds, is a powerful restorative 
in fatigue resulting from severe muscular effort, but it 
must be immediately preceded by a short hot bath, and 
must be followed by vigorous rubbing and wrapping in a 
hot blanket. 

Short cold applications cause elevation of temperature 
and increased metabolism, while prolonged cold applica- 
tions cause a fall of temperature and decrease of metabo- 
lism. 

The tonic effect of cold water is believed to be due 
to the stimulation of the sympathetic nerve-centers. The 
sympathetic nervous system controls the blood-vessels, 
heart, the functions of secretion and excretion; and, in- 
deed, all the vital functions of the body. 

The sensation of well-being which accompanies the 
reaction following a general cold application is largely 
due to an increased activity of the cerebral circulation. 



HYDROTHERAPY 33 

Cold water is a physiologic tonic, and the cold bath, prop- 
erly employed, increases the vital resistance to pathologic 
processes. 

All applications of water at a temperature low enough 
to provoke vital resistance are tonic; hence, tonic effects 
are produced by all temperatures below 90° F., but the 
most certain and pronounced results are obtained from 
the douche in every form, which adds mechanical impact 
to the thermic effects of cold. The most durable tonic 
effects are produced by the frequent use of very cold and 
very short baths. 

A tepid bath causes a lowering of the body temperature. 

The Chief Varieties of Baths. —These, in the order 
of frequency with which they are used, are: ablutions; 
tub; foot-tub; sitz; salt sponge; shower; Turkish; hori- 
zontal jet; needle; fan douche; Scotch douche; Roman and 
electric-light baths. 

Ablutions or Sponge Baths. — These baths are of 
universal use. The sponge is one of the dirtiest and most 
impossible articles of the toilet to clean and to keep clean. 
It is a collector of dirt and germs, and should be banished 
from every bath-room and from every house. It is not 
sufficient that each member of the family should have 
her own sponge; it is quite possible for the individual to 
become infected or reinfected from her own sponge. 
Incidentally, it does not afford sufficient friction, and thus 
does not favor reaction. In taking ablutions, the ap- 
plication of water may be made with the hand, though it 
is best made by means of a wash towel. The good effects 
of the simple ablution will be greatly enhanced by the use 
of the hat tub, and this especially where there is no bath- 
tub in the house. 

When the bath is taken for the purpose of cleanliness, 
the water should be warm or hot, and pure Castile soap is 
one of the best that can be used. If the skin is rough, a 
good sand soap will be more beneficial. The bath should 
be completed by dashing cold water over the body with 
the wash-towel. 

3 



34 PERSONAL HYGIENE FOR WOMEN 

The body must be quickly and thoroughly dried by 
means of a rough bath-towel. After this, the skin may 
be still further toned up by a good alcohol rub. 

If the ablution is taken simply for the tonic effect, it is 
generally taken on rising in the morning, and the water 
used is cold. The ablution may be confined to the upper 
part of the body, that is, the chest and back; and consists 
in friction with a rough wash-towel, followed by dashing 
the water over the body; followed by brisk friction with 
a rough bath-towel. This procedure causes a marked 
stimulation of the heart and lungs, and is followed by a 
rise of temperature. 

In winter all baths must be taken in a warm room. 

There is a decided increase of muscular and mental 
capacity after the cold ablution, demonstrating the tonic 
effect it has produced. 

The cold ablution may also serve as an introductory 
to other and more heroic hydriatic procedures. If the 
reaction is not good, water at a higher temperature should 
be used, and only small portions of the body should be 
attacked each day, followed always by brisk friction. 
As the reaction becomes better, the temperature of the 
water should be gradually lowered from day to day. 

There must be a decided sensation of warmth of the 
body before proceeding to take any form of cold bath. 
This may be induced by sipping a cupful of hot water 
before rising, and then being well covered with the bed- 
clothes until the body is in a glow. In conditions of 
anemia or neurasthenia, where the circulation is markedly 
poor, in addition to drinking the hot water, the bather 
may stand on hot blankets while taking the cold ablu- 
tion, and after it be rubbed briskly with hot towels. 

Nothing is gained, and a great deal of harm is done, by 
trying to persevere in the daily cold ablution when it is 
followed by a pallor of the skin, chilliness, etc. 

The Tub Bath.— This is much more refreshing, more 
salutary, and may be used to produce a much greater 
variety of effects than the simple ablution. Tub baths 



HYDROTHERAPY 35 

may be classified according to the amount of water in the 
tub as half or full tubs; and again, according to the tem- 
perature of the water, as warm, tepid, hot, and cold. 
The half tub contains about 30 gallons of water. 

In a general way it may be said that the half tub of 
warm water is used for the purpose of cleanliness; the hot 
baths for breaking up colds, for rheumatism, etc.; the 
tepid bath to allay nervousness; and the full cold tub, for 
the tonic morning dip. 

For cleansing purposes the so-called half tub, that is, 
the tub contains a sufficient amount of water to reach 
above the pelvis when one is seated in the tub, is used. 
The temperature ranges from 98° to 102° F. Five min- 
utes is as long as the bather should remain in the tub, 
as all hot baths are more or less exhausting. After an 
initial immersion in the water, the scrub takes place by 
means of the Turkish bath-towel, or, better, by the use of 
the flesh brush. If there is a shower attached, the hot bath 
should always be followed by a brief cold shower; if not, 
the cold water should be turned on and dashed over the 
body by means of the wash-towel. This closes up the 
pores of the skin, prevents the profuse perspiration from 
taking place that so often follows a hot bath, and greatly 
diminishes the susceptibility to taking cold. An alcohol 
rub completes the procedure. This insures a further 
toning up of the cutaneous vessels. A small quantity 
of alcohol is poured into the hand and applied to a limited 
area of the body. It is well rubbed in with friction until 
the alcohol has wholly evaporated. Beginning with the 
arms, the legs, chest, and back are successively gone over. 

The hot bath is best taken immediately before retiring, 
and should not be repeated oftener than twice a week. 
Retiring to bed at once, the bed acts as the cooling cham- 
ber of the Turkish bath. The hot bath is most restful, 
and, except in rare cases, tends to the production of 
refreshing sleep. 

If the bather has a weak heart, suffers from shortness 
of breath, or is weak from any cause whatever, she should 



36 PERSONAL HYGIENE FOR WOMEN 

only take a half tub bath, since it has been learned from 
experience that when the water covers the entire body, 
there is increased difficulty in the respiration, and the 
heart's action often becomes embarrassed, palpitation 
of the heart is experienced, with a feeling of impending 
suffocation. There is sometimes also a feeling of faint- 
ness. On getting into the tub, the temperature of the 
room should never be above 68° to 70° F. 

The Full Tub or Immersion Bath. — In this form of bath 
there is a complete submersion of the body in the water, 
so that the water reaches the under surface of the chin, 
the head of the bather resting on a cross strap, being the 
only portion of the body uncovered by the water. 

If the bath is tepid, that is, has a temperature of from 
80° to 90° F., great care should be taken to have the 
chest covered, in order to prevent pulmonary congestion. 
This is best accomplished by placing a Turkish towel, 
wrung out of hot water, about the chest and shoulders 
of the bather just after she enters the tub. 

If the bath is hot, from 98° to 104° F., before entering 
the bath the face and neck are rubbed with cold water, 
in order to relax the vessels of the brain and so prevent 
cerebral anemia. Except when the hot bath is given for 
especial therapeutic purposes, as for rheumatism, cystitis, 
colic, etc., it should always be followed by a cold applica- 
tion. 

The Cold Dip.— For the dip, the tub is filled with 
water at a temperature of from 65° to 55° F. The dura- 
tion of the dip varies from two or four seconds to one or 
two minutes. The bather should wet the face and chest 
before entering the water. It is best to enter the bath 
suddenly, as the sensation of cold is thus far less notice- 
able than when the bath is entered gradually. If the stay 
in the tub is more than momentary, vigorous rubbing 
must be kept up during the entire time spent in the tub. 

For persons in good health a cold dip on rising in the 
morning is excellent. It creates an appetite, accelerates 
the circulation, arouses the nervous system, and produces 



HYDROTHERAPY 37 

decided exhilarating effects in those who are strong 
enough to react after it. When employed for this pur- 
pose, the immersion should not be more than from three 
to fifteen seconds. The bather must rub herself vigor- 
ously while in the tub, and follow the bath with brisk 
toweling and plenty of friction. She should then take 
moderately active exercise for fifteen to twenty minutes. 

For any one just beginning to take the cold dips, the 
temperature of the water should be just 1 degree below 
that of the body, and gradually lowered by a drop of 1 
degree every morning or two. Or, the dip may be pre- 
ceded by a preliminary warm bath or warm shower. 

The salient point in connection with bathing is not to 
allow the skin to lose heat too rapidly. To apply this as a 
warning in the case of cold baths: it has been estimated 
that the heat loss from the body immersed in cold water 
at the temperature of 86° F. is double the normal; at 
77° F., three times, and at 68° F., five times, the normal. 

The daily use of the cold dip for those who are able to 
react after it is one of the best means of fortifying the 
system against both acute and chronic diseases. 

Contraindications. — The use of the cold dip is contra- 
indicated for young children, the aged, and in run-down 
conditions of the system; in all cases where the action of 
the heart is weak, in Bright's disease, or in any acute or 
chronic congestion of the kidneys; in all acute inflamma- 
tions, as inflammation of the bowels, peritonitis, or in- 
flammation of the uterus and ovaries. 

Alkaline Baths. — For these baths from 4 to 12 ounces 
of the carbonate of soda should be used to 30 gallons of 
water. The water should have a temperature of from 
92° to 96° F. This bath is useful in many forms of skin 
disease, and relieves the itching of jaundice and urticaria. 

Saline Baths. — The typical saline bath is the salt- 
water bath. Sea-water contains in solution from J to 
\ pound of solids to the gallon of water. The principal 
ingredients are common salt, magnesium chlorid, and 
magnesium sulphate. These substances have a decidedly 



38 PERSONAL HYGIENE FOR WOMEN 

stimulating effect upon the skin and encourage reaction. 
For an artificial sea-water bath, 8 pounds of sea-salt 
should be used to 30 gallons of water. 

Ordinary coarse salt is purer, contains from 97 to 98 
per cent, of the chlorid of sodium, is cleaner, and makes 
a clearer solution, and it dissolves in about one-third of 
the time required for sea salt, and can be obtained for 
about one-third of the cost. 

As a cleansing agent, a 5 per cent, brine is equal or 
superior to soap. Further, the axilla and hairy parts 
remain clean and sweet for a much longer time than after 
the use of soap. These brine baths, taken three times a 
week, are followed by a great improvement in the general 
health. 

The Rain Douche or Shower Bath. — The shower is 
the most tonic of all the baths that can be taken at home, 
and no bath-room should be considered complete without 
it. In this form of douche the water is projected through 
a perforated disc, falling upon the bather in a number of 
fine streams. It is necessary for the bather to wear a 
rubber cap in order to keep the hair dry. In taking the 
shower bath the bather stands up; the disc is generally 
placed about 3 feet above the head. The water should 
be allowed to fall first upon the feet, then the hands, arms, 
shoulders, back, and, lastly, upon the chest and abdomen. 
The bather should keep in active motion during the ap- 
plication, flexing the limbs, and rubbing the chest with 
the hands. At the beginning of the shower the hands 
should be placed over the chest, in order to protect the 
precordial region from the impact of the water. 

The cold shower should be preceded by some kind of a 
heating process — either a hot plunge or a hot shower bath. 
A shower of from 100° to 104° F. may be applied for one 
to three minutes before the cold application. A cool 
shower of 75° to 65° F. is an excellent training for persons 
who are sensitive to cold. The neutral shower, 92° to 
97° F., given for three to five minutes, is sedative in its 
effects. 



HYDROTHERAPY 39 

The cold shower, 60° to 70° F., duration from five to 
thirty seconds, is useful in phlegmatic neurasthenics and 
dyspeptics; sedentary people in whom the general meta- 
bolic activity is diminished ; also in obesity and in all cases 
after a sweating process. By standing in hot water the 
bather is much more tolerant of cold. 

The neutral shower is one of the most effective measures 
for the relief of insomnia; especial attention should be 
given to the back and legs. The action is quicker than 
that of the neutral immersion bath. 

As a hygienic measure, the shower bath offers a most 
agreeable and rapid means of cleansing the whole surface 
of the body. 

Since the effect of the douche depends on the pressure, 
it will be readily understood that the hose attached to the 
faucet of the domestic bath-tub is merely a sprinkler, 
and not a douche, in the proper sense of the word. Such 
a procedure can only be tolerated by the most robust. 
In the upper stories of most city houses the pressure is 
probably not more than from 3 to 10 pounds; the stream 
of water from the sprinkler is really only a drizzle; the 
mechanical effects being so slight, there is no reaction 
produced; the result is that its use is followed by a feeling 
of chilliness and depression. 

The Hot Foot-bajth. — The temperature of this bath 
should be at the beginning from 102° to 104° F., and the 
duration from three minutes to half an hour. The pail 
is nearly filled with water, care being taken that it shall 
not be so full as to overrun when the feet and legs of the 
bather are put in. A blanket, closely wrapped about the 
patient and the pail, should come up above the knees. 
As the water cools off, hot water should be added. 

This form of bath is most commonly used to relieve 
congestion and inflammation. The dilatation produced in 
the blood-vessels of the feet and legs relieves congestion of 
the brain and the organs of the upper half of the body, 
as well as of the pelvic viscera. It should be taken imme- 
diately before retiring. 



40 PERSONAL HYGIENE FOR WOMEN 

The Sitz Bath. — The sitz or hip bath requires a tub 
made for that particular purpose. The back of the tub, 
which is most commonly made of tin, is cut high, while the 
front must be sufficiently low for the patient to sit com- 
fortably in it, without undue pressure being made on the 
under side of the knees. 

The tub is half filled with water of the prescribed tem- 
perature. It is well to begin with water at a temperature 
of 102° F., and increase the temperature while the patient 
is in the tub, making it as hot as is comfortable. 

In giving all hot baths a thermometer must be used, and 
a word of warning must be given about adding hot water 




Fig. 2. — Sitz-bath tub made of tin (Ashton). 

in case of sickness, as well-authenticated cases of paral- 
ysis are recorded in which the temperature sense of the 
patient was lost, and, in adding hot water, it was raised 
to such a temperature that the legs and feet of the patient 
were scalded. * 

During the sitz bath the patient keeps on her stockings 
and bedroom slippers, and, unless friction is ordered, the 
entire body, as well as the feet and legs, are enveloped in 
blankets. 

The duration of this bath is from three to ten minutes. 



HYDROTHERAPY 41 

This bath is especially useful in restoring the menstrual 
function when it has been suspended as the result of 
chill or other causes; also, for relieving hemorrhoids, 
uterine colic, neuralgia of the ovaries, and inflammation 
of the bladder. 

To prolong the effect of the bath the patient may be 
put to bed wrapped up in her blankets. In cold weather 
it is a good precautionary measure to have the bed heated 
with hot-water bottles, in order to prevent chilling. 

Salt Ablution. — As the name indicates, this is a salt- 
water bath, and the best results are obtained by using 
a saturated solution, which is in the proportion of 1 pint 
of salt to 1 gallon of water. Sea-salt is the best, but, if 
that cannot be obtained, ordinary salt may be used. 

If there is no bath-tub in the house an ordinary wash- 
bowl may be used, but the bath is most effective when 
taken in the tub. The salt and water are put in a papier- 
mache pail, which is placed at the foot of the tub. The 
chilliness which might be caused by sitting on the cold 
porcelain is avoided by placing a heavy folded bath-towel 
on the bottom of the tub. In cold weather the tub 
should be previously heated by allowing the hot water 
to run in. 

The salt water feels very much colder than plain water 
at the same temperature. It is well to begin with a tem- 
perature of from 90° to 85° F., and gradually lower the 
temperature until 70° F. is reached. 

The water is applied by means of a Turkish wash- 
towel, accompanied by vigorous friction, beginning with 
the face and neck, arms, legs, back, and, lastly, the chest 
and abdomen are gone over. After that, the water is 
dashed over the entire body, and is followed by a brisk 
toweling and friction with the hands or hair glove. 
The salt water should not be washed off, except in those 
rare cases where it causes a disagreeable sensation; it is 
then removed by the use of the hot followed by the cold 
shower, as previously directed. 

Indications for Its Use. — It is an excellent nerve tonic 



42 PERSONAL HYGIENE FOR WOMEN 

in cases of depression with loss of appetite, insomnia, 
etc., also in anemia and neurasthenia. In this class of 
cases it is best taken in the afternoon, on rising from the 
siesta, and just before dressing for dinner. It is especially 
refreshing in the hot weather. 

Its use is contraindicated under the same conditions that 
other cold baths are, and must never be taken when the 
bather has a tendency to chilliness. 

The various kinds of baths previously described can all 
be obtained in the home, but the Turkish bath, with its 
various accessories, can only be taken in a properly 
equipped bathing establishment. 

The Turkish Bath. — This form of bath dates back to 
the time of the Romans. The essential features of a 
modern establishment are: dressing-rooms; a warm room, 
with a temperature of from 110° to 130° F.; a hot room, 
temperature of 150° to 170° F.; a steam room; a shampoo 
room; a douche apparatus; a plunge bath, and a cooling 
room. In many establishments there is only one hot, 
dry-air room. The air of the room may be heated by 
steam-coils. 

The bather, having disrobed, is enveloped in a sheet, 
and enters the hot room, where she reclines on a steamer- 
chair. A towel wrung out of cold water is placed on the 
forehead and changed as often as it becomes hot. The 
bather should drink a glass of cold water immediately 
before or on entering the hot room, and several glasses 
should be taken at intervals during her stay in this room. 

The skin is highly stimulated and profuse perspiration 
results. The profuse sweating promotes absorption from 
the alimentary canal, and so is a powerful stimulant to 
nutrition. It also emphasizes the necessity for copious 
water-drinking. 

Great harm often results from a too prolonged stay in 
this room. Ordinarily, the bather should leave the room 
as soon as free perspiration is established; that is, in from 
fifteen minutes to half an hour. 

From this room the bather next enters the Russian 



HYDROTHERAPY 43 

bath or steam room. It is very much more agreeable to 
have very little steam in the room on entering; when the 
steam is very dense, a feeling of suffocation may occur. 
Any one with a weak heart should avoid the steam room 
altogether, as it is apt to cause a sense of great oppression. 
For the complexion, bronchitis, or laryngitis, it is excellent. 

From the hot room the bather goes to the shampoo- 
room, where, lying upon a marble slab, she is first gone 
over from head to feet by the wet hands of the attendant. 
This manipulation removes the layer of cuticle which has 
been loosened by the free perspiration. These rubbings 
and strokings are continued until the skin feels smooth 
and polished. 

The bather is next shampooed with soap and water, 
applied with a bath-brush. This n may in turn be followed 
by a salt rub. After this comes a douche, given with a 
horizontal jet, at a temperature of 104° to 106° F., fol- 
lowed by a cold douche. 

If the bather is a strong woman, she may now enter the 
cold plunge. The temperature of this should be from 70 ° 
to 60° F.; this must only be a quick dip. She is then 
vigorously rubbed and dried. After this she lies down in 
the cooling room and has an alcohol rub, which completes 
the procedure. She should rest here for half an hour at 
least before dressing. The pulse should be normal and 
the skin perfectly dry before she dresses and goes out on 
the street. 

In winter, instead of the ordinary alcohol rub which is 
given, it is much better to have a thorough massage with 
cocoa-butter or almond oil — the so-called Roman bath. 
Just following the Turkish bath much of this oil will be 
absorbed, which is beneficial for thin people, and, in any 
case, it will lessen the danger of getting chilled on going 
out into the cold air. 

The woman unaccustomed to these baths should under 
no circumstances go to a Turkish bath without consulting 
her physician, as great harm might result. The bath 
should not be taken oftener than twice a week, unless by 



44 PERSONAL HYGIENE FOR WOMEN 

special orders of the physician. Care must be taken not 
to overuse them, as frequent and prolonged exposures 
to the sedative influence of heat is very debilitating. 
The wise woman will provide her own bathing cap, bath- 
brush, and straw sandals. 

The use of the Turkish bath is indicated in rheumatism, 
toxemia, chronic dyspepsia, biliousness, obesity, sciatica, 
and lumbago. 

The contraindications to its use are, in Bright's disease 
of the kidneys, in most pulmonary affections, in the ad- 
vanced stages of arteriosclerosis, and in diabetes with 
emaciation. 

The Electric-light Bath. — This is now frequently 
used instead of the hot-air room of the Turkish bath, and 
possesses many advantages. A cabinet is lined on three 
sides with mirrors, on which are arranged 50 or 60 
electric-light bulbs; the mirrors multiply the number of 
lights by reflection. A stool is placed in the cabinet for 
the patient to sit on, while the head protrudes above the 
top, which is closed. By means of switches and a proper 
grouping of the lamps in wiring, the number of lights, and 
so the temperature, can be instantly and perfectly con- 
trolled. The heat is derived by radiation, so that it is 
not necessary to have the air confined. In this form of 
light bath the body is directly exposed to the effects of 
radiant light and heat. 

The incandescent electric-light bath is superior to every 
other form of heating procedure in which the only object is 
the preparation for the cold bath. The time required 
is not more than from three to five minutes. When it is 
desired to produce profuse perspiration, the patient may 
remain in from eight to fifteen minutes. A longer stay 
than this is apt to produce an overstimulation of the 
nervous system and an excessive elevation of tempera- 
ture. 

The electric-light bath possesses the distinct advantages 
that, while the body is exposed to a high degree of heat, 
the air of the room in which the head is, and which one 



HYDROTHERAPY 45 

is breathing, may be cool, and unique advantages in the 
exactness of the dosage as regards time and intensity. 
It can also be used in a much greater number of diseases 
than the hot-air room of the Turkish bath. 

The finishing treatment on leaving the cabinet is iden- 
tically the same as that for the ordinary Turkish bath. 

Indications for Its Use. — While the electric-light bath 
is not a complete substitute for sweating produced by 
exercise, it comes nearer to that than any other heating 
procedure, and, when followed by some vigorous cold 
application, it possesses a hygienic value which cannot be 
overestimated. 

It is especially valuable in cardiac disease and diabetes. 
It stimulates oxidation, and is thus valuable in obesity 
and the toxemia of chronic dyspepsia; also in malarial 
cachexia, syphilis, neuritis, neuralgia, sciatica, habit 
chorea, hysteria, rheumatism, and anemia. 

It is superior to all other treatment in chronic rheuma- 
tism and all diseases dependent on uric-acid diathesis or 
diminished metabolism, by the combined action of the 
elevation of temperature and the vigorous cutaneous 
activity. The elevated temperature stimulates the oxida- 
tion of the proteid wastes and augments vital combustion, 
while the increased skin activity carries off all waste- 
products prepared for elimination. 

As a prophylactic, this form of bath is especially valu- 
able for all persons leading a sedentary life; it is the best 
substitute for exercise in the open air, and, where there 
are no contraindications to its use, should be taken once a 
week. 

In cases of obesity, sweating may be used to reduce the 
weight; but, in order to obtain the best effects, it must be 
combined with exercise, and it must be borne in mind, 
that in obesity there is great danger of overheating the 
blood, in consequence of the obstacles to heat elimination 
presented by the thick layers of non-conducting fat. There- 
fore, these hot applications for the reduction of fat should 
never be too much prolonged, and the bath should always 



46 PERSONAL HYGIENE FOR WOMEN 

be finished by vigorous applications of cold. These 
cold applications have also a tonic effect upon the nervous 
system, and increase the muscular disposition for exercise, 
and this is the most rational treatment for obesity. 

Loss of Weight. — There are many cases in which metabo- 
lism has been so sluggish, allowing an accumulation of 
imperfectly oxidized matters in the body, that the first 
active stimulation of the nutritive processes is in dis- 
proportion to the increased destructive metabolism. 
Under these circumstances there is necessarily a decrease 
in weight. The rubbish must first be removed and 
old defective structures before new and highly organized 
tissues can be deposited. A slight loss of weight need, 
therefore, give rise to no apprehension, but if the loss is 
considerable, or continues for some time, especially if 
accompanied by loss of strength or appetite, it is a matter 
for investigation. 

Palpitation of the heart and fulness of the head are an 
indication that the applications have been too hot or too 
long continued. Vertigo and fainting are apt to occur 
when hot applications have been continued too long, but 
they are quickly relieved by cold applications, especially 
by cold affusions to the chest and shoulders. Headache 
may result, either from excessively hot or cold procedures. 
Deficient reaction is generally the result of a too prolonged 
application of cold. 

On entering the electric-light cabinet, a wet towel 
wrung out of ice-water is placed around the neck and 
another around the forehead ; or an ice-bag may be placed 
on the top of the head. 

The Douche. — A douche consists of a single or multiple 
columns of water directed against some portion of the body. 
The apparatus is complicated, and it is essential that an 
accurate pressure-gauge and thermometer should be intro- 
duced into the circuit of the douche. It can only be 
properly administered in a hydriatic establishment. In 
the employment of the douche three factors must be con- 
sidered — the temperature, pressure, and the mass. 



HYDROTHERAPY 47 

The range of temperature employed varies from 45° 
to 125° F. The pressure ordinarily employed varies from 
10 to 60 pounds. The mass varies according to the effect 
desired, and may be regulated by means of the finger, 
placed in the water column near the nozzle. 

The douche is applied by means of the rubber hose, 
which is connected at its proximal end with the water- 
supply, and at its distal end is attached a nozzle, the 
average diameter of which varies from 2 inches to § inch. 
From these a fine or coarse jet or a fan douche may be 
produced. The latter is formed by placing the index- 
finger of the hand holding the nozzle upon the lower bor- 
der of the outlet, producing an expansion of the otherwise 
solid jet into a fan-shaped stream. 

The mechanical effects of the douche are derived from 
atmospheric pressure, and this is of more importance in the 
effects produced than the temperature. 

The Scotch douche consists of alternate streams of hot 
and cold water. The general cold douche is the most 
powerful of all the tonics; the warm or neutral douche is 
sedative; the very hot douche is frequently followed by 
atonic reactions. 

Rationale of the Douche. — The douche is a thermic 
massage. Since the douche is a sorbefacient of pathologic 
products, the French have availed themselves of its use to 
aid the body to throw off an excess of uric acid, fatigue 
toxins, etc. 

It has been demonstrated that a rain douche of 50° F., 
under a pressure of two atmospheres, increases threefold 
the work that the muscles are capable of doing, while 
the Scotch douche, oscillating between 98° and 53° F., 
doubles the working capacity of the muscles. Even tepid 
douches increase the working capacity of the muscles, 
while a tub-bath of the same temperature is without decided 
effect. The pressure under which the douche is given 
adds a powerful element, which is absent in other hydriatic 
procedures. The percussion and vibration affect the 



48 PERSONAL HYGIENE FOR WOMEN 

vasomotor system much more powerfully than any form 
of still bathing. 

The power and action of the heart are greatly improved 
by the use of the douche, the capacity of the lungs is in- 
creased, and the digestion is improved. 

Brief douches of from ten to fifteen seconds generally 
act better than those of longer duration. The general 
condition of the patient must always be carefully studied, 
and, like the Turkish bath, the douche should always be 
taken under the direction of a physician, as they are also 
capable of doing a great amount of harm as well as good. 
The best results from the douche are obtained when it is 
taken following the use of the electric-light bath. 

The neutral douche is particularly applicable in cardiac 
affections and in cases of high arterial tension. The 
sensation afforded should not be either that of hot or cold, 
and the duration from one to two minutes. The douche 
for this purpose should be given with only a slight degree 
of pressure, and to avoid irritation it should be directed 
to either side of the spinal column. This is a sedative 
application. 

Contraindications for the Use of the Douche. — In all 
acute inflammations and in eruptive disorders of the skin. 
The cold douche is contraindicated in inflammation of the 
uterus, ovaries, kidneys, stomach, liver, bowels, and 
bladder, in intestinal catarrh, chronic inflammation of the 
stomach, and general neuritis. It must also be avoided 
in rheumatism, arteriosclerosis, cardiac insufficiency, 
valvular diseases of the heart with deficient compensation, 
fatty degeneration of the heart, and in cases of extreme 
nervous irritability. 

The Internal Use of Water. — The internal use of 
water is essential to life. Water constitutes about two- 
thirds of the body weight; it is found in every tissue and 
organ of the body; it acts to dilute the foods so that they 
can be absorbed from the digestive tract; its presence in the 
blood is essential, both to carry foods to the tissues and to 
convey the waste matter away from the tissues. Its use 



HYDROTHERAPY 49 

in the form of a lavage is even more necessary, to keep 
clean and free from impurities the mucous membrane 
lining the 30 feet of the digestive canal and the tubules of 
the kidneys than is the external use of water to keep 
the skin in a healthy condition. Its use is also needed 
to "keep the blood-pressure and the heart in a normal 
condition. 

About 4J pints of water are given off daily in the excreta 
and exhalations; but, since about one-half of the solid 
foods taken consist of water, 3 pints of water, taken daily 
as such, are sufficient to counterbalance the loss. 

All water for drinking purposes should be filtered. The 
best method is to have a filter attached to the pipes of the 
house-supply, so as to insure filtered water running from 
all the spigots. 

If the water is not filtered, it should be boiled for thirty 
minutes. The water should be run off in the morning, 
then poured into a well-kept tea-kettle and boiled. It is 
then allowed to stand and become partially cooled in 
covered vessels, when it is poured into large bottles — 
quarts are the most convenient size; these should be stop- 
pered with corks of absorbent cotton. When cool, the 
bottles are placed in the refrigerator beside the ice. 
Water should be boiled every morning for the twenty- 
four hours. Boiling for this length of time secures the 
destruction of all the germs of disease, and it is doubly 
essential on the return to town in the fall, when the house 
has been closed for some time; also when typhoid fever in 
the neighborhood indicates the strong possibility of the 
impurity of the water-supply. 

The mistake should not be made of undoing the good 
that has been done by boiling the water by the addition of 
ice to the water when it is placed on the table. Further- 
more, ice-water is so cold that it retards and interferes 
with the digestive processes. 

In the internal use of water the same marked difference 
is caused by the different temperatures at which the 
water is taken, as was seen in the external applications of 

4 



50 PERSONAL HYGIENE FOR WOMEN 

water; but, while the temperature of the skin is about 90° 
F., that of the mucous membrane lining the digestive 
tract is 98.6° F. and above. 

The Action of the Internal Use of Water on the Heart and 
Blood. — Water improves the quality of the blood, both by 
its direct action on the constituents and by the increased 
elimination of waste-products. By the increase of the 
volume of blood, a more energetic contraction of the heart 
is caused, and the activity of all the glands of the body is 
increased. There is a greater amount of oxygen absorbed 
by the lungs; oxidation in the tissues is carried on more 
perfectly, the result of which is that there is a diminution 
or absence of the products of incomplete combustion in the 
body, such as uric acid, the oxalates, etc. 

By the increase of the blood-pressure, caused by drink- 
ing water in sufficient quantities, the activity of the kid- 
neys is increased, and this not only in the amount of urine 
passed, but also of the solid constituents, which are the 
waste-products, removed from the body through the 
agency of the kidneys. 

The Action of Water on the Digestion. — Very little water 
is absorbed from the stomach ; it passes from the stomach 
to the intestines, where it is absorbed. In order to ob- 
tain a thorough cleansing of the stomach, and at the 
same time not to cause its overdistention, not less than 
J pint of water and not more than 1J pints should be 
taken at one time. The water must be taken one hour 
before meals, in order to insure its removal from the stom- 
ach and the proper rest of that organ before food enters 
it, as it has been found by actual experiment that in a 
quarter of an hour after water had been taken one-half 
of the quantity remained in the stomach, but that none 
remained after the lapse of half an hour. Cold water is 
more quickly absorbed than warm, and the absorption 
is hastened by the presence of carbonic acid, while salt of 
any kind delays its absorption. 

The Therapeutic Indications for the Use of Water. — 
First, the temperature of the water taken must be regu- 



HYDROTHERAPY 51 

lated by the effect desired. Briefly stated, if the water 
is taken for dyspepsia in any form, whether acute or 
chronic catarrhal inflammation of the stomach or the 
intestinal canal, \ pint of water, just as hot as it can be 
sipped with a spoon, should be taken three times a day, 
one hour before each meal. ■ 

No water should be taken during the meal, and only 
one glass, at a temperature of about 60° F., on its com- 
pletion. 

If the water is taken as a diuretic, or, in other words, 
to increase the activity of the kidneys, the most of the 
water should be taken in the morning on rising and the 
remainder about 4 o'clock in the afternoon. Probably 
the best natural waters for this purpose are the waters of 
the Vosges, France. The Vittel water, "Grande Source," 
acts on the kidneys alone; where the bowels are regular 
or inclined to be loose, this is the best water to use. If, 
on the contrary, there is constipation or biliousness, the 
"Source Salee" should be taken in connection with the 
first named or alone. The "Source Salee" has a decided 
action on the liver and is laxative. 

In order to obtain a pronounced effect, at least 3 pints 
of these waters should be taken daily; in some cases more 
is required. Two glasses may be taken on rising in the 
morning, with an interval of twenty minutes between; 
the last glass must be taken one hour before breakfast. 
The temperature of the water should be 50° F., which is 
the temperature of the water at the springs and that of the 
water when placed in bottles in the refrigerator against 
the ice. In the afternoon the other two glasses may be 
taken, with the same interval between. 

In gastric catarrh, where there is an accumulation of 
mucus or fermenting matter, with or without nausea and 
vomiting, hot water alone is useful. In addition to its 
action in diluting the contents of the stomach and the 
intestines, and its cleansing and antiseptic effect on their 
mucous membranes, the reflex effect of very hot water, 
slowly sipped, is a stimulation of their muscular coats, 



52 PERSONAL HYGIENE FOR WOMEN 

r 

which furthers the passage of the digested food from the 
stomach into the intestines. The quantity taken must 
be from ^ to 1 pint, in order to obtain a thorough cleansing 
and yet not to cause an overdistention of the stomach. 

In acute nephritis, inflammation of the kidneys, small 
quantities of very cold water, repeated at half-hourly 
intervals, act as a diuretic. Care must be had, however, 
not to overtax the stomach and heart by overfilling 
the system with fluids. 

In obesity, water-drinking is essential as a means of dis- 
solving and carrying out of the body the large amount of 
broken-down material which results from the increased 
tissue destruction caused by exercise, hot and cold baths, 
and other means employed to decrease the weight. 

For constipation and biliousness two glasses of cold 
water should be taken before breakfast, with an interval 
of twenty minutes between, the last glass being taken 
one hour before breakfast. 

Contraindications. — Cold water taken into the stomach 
produces more marked effects than water applied to an 
equal area of the skin. The quantity of water taken is 
a factor as well as the temperature. Cold-water drinking 
lowers the temperature and slows the pulse, so that drink- 
ing cold water must be strictly prohibited when one is 
in a state of fatigue, whether perspiring or not. Feeble 
persons should not drink cold water, except in very hot 
weather, or just before starting out for a brisk walk in the 
open air, or when about to engage in other exercise. With 
the air of the room at 70° F., a woman in fair condition, 
moving about making her toilet, may safely drink cold 
water slowly, except when there is a feeling of chilliness. 
In the latter case, the powers of reaction being diminished, 
chill and internal congestion, often resulting in great 
injury, may be produced. Cold-water drinking is always 
prohibited when in a state of fatigue. Ice-water should 
never be taken. When taken with meals, it greatly 
retards digestion and may do much harm. 



HYDROTHERAPY 53 

Enemas. — Coloclysters. — Another valuable internal 
use of water is for emptying the lower bowel, and washing 
out the large bowel in cases of catarrhal inflammation. 

For constipation, in which the object is to unload the 
bowel as quickly as possible, 1 or 2 pints of water, at a 
temperature of from 104° to 110° F., is made into a suds 
by means of Castile or other good soap, and poured into 
a fountain-syringe. If the enema is being given by an 
attendant, the patient lies on the right side in the Sims' 
position; the under leg is stretched out so that it forms 
a straight line with the trunk, while the upper leg is sharply 
flexed at the knee, so that the foot is opposite the knee 
of the under leg; the right arm is thrown back from under 
the body. 

If the patient is administering the enema to herself, 
the best position is the knee-chest. In this the patient 
kneels on the floor, the thighs are held rigid, and while the 
shoulders are brought to touch the floor, the face is turned 
to one side. The position can only be taken satisfactorily 
with the corsets and all tight bands around the waist 
removed. In this position gravity causes the intestines 
to fall upward toward the waist, and the water naturally 
follows this course. In this position the water goes up 
higher, and is retained longer, than when taken in the 
other positions. Two pints of the soap-suds are prepared 
at the proper temperature, and the patient uses as much 
of this as she feels that she can retain. The water should 
be retained from five to ten minutes, to get the best results. 

For the purpose of washing out the large intestine more 
water is used, but not more than 2 quarts should be used 
for this. The position of the patient and the temperature 
of the water are the same. But for this clyster, instead of 
adding soap to the water, cooking salt is used, in the 
proportion of 1 teaspoonful of salt to 1 pint of water. 

This lavage of the intestine removes rapidly large masses 
of decomposing material, swarming with microbes and 
ptomains and the toxins produced by them. It also 
increases the activity of the portal circulation. 



54 PERSONAL HYGIENE FOR WOMEN 

In cases of chronic constipation there are atony and 
dilatation of the colon, and the patient always carries 
about with her an enormous accumulation of fecal matter, 
and lives in a state of chronic autointoxication. In this 
class of cases the coloclyster should be administered daily 
for from two to three weeks; if need be, so long as the 
patient complains of gaseous distention and fetid flatu- 
lence. After the discharge of the warm water, 1 pint of 
cool water should be introduced, beginning with a tem- 
perature of 85° F., and gradually decreasing this from 
day to day until 70° F. is reached. This water should 
be retained if possible; it acts as a tonic bath for the colon. 

Care should be exercised to avoid the distention of the 
colon by an excessive amount of water, and, after the 
colon has been thoroughly cleansed, the amount of water 
used should be decreased from day to day, until finally 
only 1 pint is used. Warm water is always relaxing, 
whereas cold water stimulates and tones up the bowel. 
If the quantity of water used is small, the cold coloclyster 
may be used indefinitely without producing constipating 
effects. 

Great care must be used to avoid the introduction of air 
into the bowel with the water; to this end the water is 
allowed to run out of the nozzle before its introduction 
into the rectum. A small-sized nozzle should always be 
used, and this should be lubricated with vaselin or some 
other emollient, in order to prevent irritation of the mucous 
membrane. 

Vaginal Irrigations. — To be of any service the vaginal 
douche should be taken in the horizontal position. It 
may be taken on the bed, couch, or lying on the floor. 
When taken on the floor, a heavy rug or steamer blanket 
should be doubled four times, and two pillows are used: 
the under one goes up and down for the support of the 
back, while the second is used for the support of the head. 
A douche-pan is, of course, indispensable. The agate pans 
holding 4 quarts of water are the most serviceable. The 
douche-pan is placed against the lower edge of the under 



HYDROTHERAPY 55 

pillow, which is protected by a bath-towel. The woman 
must throw a heavy shawl or blanket over herself while 
taking the douche, otherwise there is great danger of 
becoming chilled, and thus doing actual harm instead of 
good. 

The most common and best form of syringe is the foun- 
tain-syringe. This is hung about 6 feet above the bed or 
floor. It should hold 4 quarts of water; this quantity of 
water is necessary when the douche is given, as it most 
commonly is, for pelvic inflammation. On beginning 
its use, the temperature of the water must be controlled 
by the sensitiveness of the patient ; generally one can use 
a temperature of at least 112° F., but not always; some- 
times one must be content with a beginning temperature 
as low as 104° F., gradually increasing the temperature by 
two degrees every few days, until from 114° to 120° F. is 
reached. The use of a bath thermometer is always essen- 
tial to test the temperature of the water. The tempera- 
ture of the douche should never go above 120° F., or 
actual harm will be done. 

On lying down, the lower part of the body rests on the 
broad strip of the douche-pan, the nates coming over the 
edge, and the clothing well pushed up, otherwise the 
water will seep up the back. 

The water acts as a hot poultice about the uterus and its 
adnexa; it is also astringent, and greatly relieves ovarian 
irritation and congestion. It is highly sedative, and is 
best used at night just before retiring. In severe cases 
better results will be obtained by its use twice daily. In 
that case one douche must be taken in the morning, but 
in cold weather it must never be taken immediately 
before going out-of-doors ; there must be at least one hour 
between the time of taking the douche and going out into 
the cold air. Patients taking hot douches must be 
warned that the pelvic viscera are much more susceptible 
of chilling because of these heating procedures, and of the 
necessity to counteract this tendency by the wearing of 
woolen abdominal bands, both night and day. * 



56 PERSONAL HYGIENE FOR WOMEN 

Ordinarily, plain hot water is all that is necessary 
to use, but if the vaginal discharge is irritating, one tea- 
spoonful of borax may be added to the pint of water; or 
one teaspoonful of cooking salt; or one-half teaspoonful 
of the sulphate of zinc. 

Douching the Ear. — This procedure is made use of to 
remove impacted ear-wax or to relieve the pain of earache. 
A small fountain syringe should be used, hung not more 
than 3 feet above the head. The water should have a 
temperature of from 105° to 110° F. The nozzle must 
be small, and have a very fine opening, and great care 
must be used in its introduction not to allow the nozzle 
to enter beyond the external opening of the ear. A pus- 
basin or small dish may be used to protect the clothing 
from getting wet. After the procedure is finished, the 
ear is dried by means of a very fine handkerchief or a 
little absorbent cotton. 



CHAPTER III 

THE CARE OF THE SKIN AND ITS APPENDAGES 

The Complexion; the Action of the Bath in Health; the Proper 
Time to Bathe; the Care of Wash-cloths; Cleansing the Face; Pro- 
tection of the Face; the Use of So-called Cosmetics for the Face; 
Facial Blemishes, Freckles, Liver Spots, Sallow Complexion, Pim- 
ples, Acne, Eczema, Wrinkles, and Their Treatment; the Relation 
of Diseases of the Skin to Internal Disorders. 

The Hair; Dandruff; Causes and Treatment of Premature Thin- 
ness of the Hair and Baldness; the Care of the Hair; Gray Hair. 

The Cosmetic Care and Treatment of the Hands; Cosmetic of 
the Nails; the Care of the Feet; Painful Affections of the Feet. 

The face is a complete index of the life of the individual 
written large, so that he who runs may read. By looking 
at the condition of the skin and the whites of the eyes we 
can judge very fairly of the digestion. From the dulness 
or brilliancy of the eyes we can make a very good diagnosis 
of the mental condition. From the general expression of 
the face we can read the kind of life that has been led by 
the individual, whether of pleasure, dissipation, or sorrow. 

From greatest antiquity men and women have striven 
to beautify their bodies. To be indifferent to the personal 
appearance is an indication of some abnormal condition in 
the individual or her environment. 

The Complexion. — The skin of the face is known as the 
complexion, and this is the part of the skin that is most 
exposed to the vicissitudes of dust and grime of the 
streets or of the occupation, as well as to heat, cold, and 
winds. 

An ideal complexion combines the qualities of clearness, 
translucency, and fineness of the outer skin, with a proper 
disposition of the blood-supply. 

57 



58 PERSONAL HYGIENE FOR WOMEN 

The beauty of the skin is evidence of good respiration, 
good digestion, proper excretion by the bowels, skin, and 
kidneys, good condition of the blood, and plenty of out- 
door exercise. 

It is now well known that the skin, as well as other parts 
of the body, depends for its integrity upon the general 
nervous system. Disturbance anywhere in the body acts 
upon the central nervous system. A simple case of indi- 
gestion often manifests itself over considerable areas of the 
skin. 

It cannot be too earnestly impressed on the reader that 
beauty is entirely dependent on the health. It will 
readily be seen that no external applications can produce 
such qualities as fineness of texture, translucency, and 
delicate play of coloring produced by the contraction 
and dilatation of the blood-vessels. 

The natural order in which to consider the skin will be 
first as subservient to health, and then as it is conducive 
to beauty. 

The Action of the Bath in Health. — Not only in the 
art of pleasing, but in the maintenance of health, neatness 
of person must be carried to perfection. By the use of 
friction, soap and water, the scarf-skin becomes more and 
more constantly renewed by the layers underneath it. 
It becomes softer, more pliant, and finer than satin in 
appearance and texture. Besides this, as has already 
been shown, bathing has upon the corium or true skin, 
and thence upon the general system, a revitalizing in- 
fluence. Combined with the proper kinds of soap, 
avoiding the use of irritating ones, bathing removes from 
the skin all effete oily matters, scales of the scarf-skin, 
crusts, the saline matters excreted by the perspiration, 
dust of all kinds, soot, particularly that from the clothing, 
and so forth. 

Caustic soaps and borax in excess may remove the oil 
in so great quantities as to be detrimental to the skin. 

Within twenty-four hours the skin, especially those 



PLATE I 



.... 




"3 

r" 




THE CARE OF THE SKIN AND ITS APPENDAGES 59 

parts which are covered, beconles vested with a pellicle 
of impurities, which, when allowed to remain, become 
thicker every day, and may produce injurious effects by 
obstructing the excretory openings and affording lodge- 
ment for disease. The effects would be felt not only in the 
skin, but in the whole organism. The skin when not 
cleansed will be irritated chemically and mechanically. 

The Proper Time to Bathe. — This depends on the 
nature of the bath to be taken, the strength of the woman, 
the temperature of the room, and the season of the year. 

To repeat, a cold bath of any description must never 
be taken unless the body has a decided sensation of 
warmth. In winter, if she will drink a glass of hot water 
before rising and has a warm room, the woman in average 
health may take a cold sponge bath. But the body must 
be very gradually trained to the application of cold, just as 
it is to vigorous muscular exercise. For the woman who 
has never in her life taken a cold bath of any sort, except 
in midsummer, to begin a heroic treatment with cold 
baths in winter would be utter folly, which might easily be 
the cause of pneumonia and even of death. The time to 
begin a systematic use of cold water is in summer, con- 
tinued through the autumn, and by the time midwinter 
has arrived, the system has become so toned up that noth- 
ing but good can result. 

If the woman is not very strong, she had better begin 
with the cold ablutions, just to the waist, on rising in the 
morning. These must always be followed by a vigorous 
toweling and friction. In case of inflammation of the 
kidneys or pelvic viscera, cold applications to the abdomen 
should be avoided, as they are badly borne. 

If the woman is anemic, has a poor circulation, or is con- 
scious of her heart, she will feel at her best in the after- 
noon. In that case, after a cup of hot bouillon, taken 
on rising from her siesta, she may take a quick hot scrub, 
followed by a cold shower. This is much more invigorat- 
ing than the cold ablution, and the reaction at that time 
of the day is more vigorous than in the early morning. 



60 PERSONAL HYGIENE FOR WOMEN 

From the simple ablution, the next step in training 
would be the cold wet sheet. It is impossible to take 
this without an attendant, but a good maid may readily 
be taught to give the necessary rubbing. Ordinarily, 
this will be enough to attempt in one winter. 

A strong woman, who has always been accustomed to 
taking cold baths, may all the year round, except- just 
before, during, and immediately after the menstrual period, 
take a cold dip on rising in the morning. It must be 
literally a quick dip in a tubful of cold water, from 65° 
to 55° F., or, if she is sufficiently strong to stay in the tub 
longer, there must be a constant brisk friction kept up 
while in the water. 

It is permitted only a woman in good health, with a 
strong heart and normal kidneys, to get into a tub of 
cold water, take a cold plunge, or attempt sea-bathing. 

For the woman who is a semi-invalid, the only time 
allowable for a cold tonic bath is in the afternoon. 

In cold weather the shower, like all other forms of baths, 
must be taken in a warm room. The shower bath can be 
taken every day to the greatest possible advantage. An 
ideal way is to rest for half an hour on coming home in the 
afternoon; to sleep, if possible, then take a quick scrub, 
and follow it first by the hot shower of 100° to 104° F., 
and finish with the cold shower. A brisk rubbing should 
be kept up until the skin is in a good healthy glow. 
This bath is followed by a feeling of great exhilaration, 
and it gives a beautiful glow to the face and skin. It 
removes the tired feeling of the day's work, and leaves 
one feeling greatly refreshed for the evening. A daily 
ablution or a daily shower, with friction, will not cause an 
undue removal of the oil of the skin. All cold baths, when 
given in suitable cases, tone up the system to resist dis- 
ease, and are the best preventives against ordinary colds 
and sore throat. 

A hot tub-bath is best taken at night just before retir- 
ing. In winter it must never be taken immediately before 



THE CARE OF THE SKIN AND ITS APPENDAGES 61 

going out-of-doors, because the pores of the skin are more 
or less open and there is great danger of chilling. A hot 
tub-bath, remaining in the bath for some minutes, should 
not be taken more than twice a week, as it is too debilitat- 
ing, and a prolonged stay in the hot water causes an actual 
loss of flesh. 

A woman may take a warm sponge bath in a warm room 
at any time of the month, but during the menstrual period 
she must, under no consideration, take a cold tub-bath or 
even a cold sponge-bath, since this would be apt to cause 
a chill of the surface of the body and a congestion, if not 
an actual inflammation, of the pelvic organs. 

No bath should be taken within two hours after eating, 
as the bath draws the blood from the stomach toward the 
surface of the body and so interferes with digestion. 

The Care of Wash-cloths. — After using each time, the 
wash-cloth must be thoroughly washed, well rinsed, and 
hung up to dry. But this is not sufficient: once every 
week all wash-cloths must be sent to the laundry to be 
boiled, thus insuring the destroying of any germs that may 
lurk in the cloth. If a woman has any kind of skin disease, 
it is quite possible for her to reinfect herself after the dis- 
ease has apparently become cured. Further, each mem- 
ber of the family should have her own individual towels, 
soap, and wash-cloths. Aside from all sanitary questions, 
in a matter so intimate as the bath, there is something 
repulsive in the thought of having your toilet articles 
used by any one else. 

A pure Castile soap is one of the best that can be used. 
All cheap scented soaps should be avoided, as they are 
apt to contain impure materials that will actually injure 
the skin. If the skin is rough, rubbing it with a good 
sand-soap, and rubbing the same on the flesh-brush, will 
remove many of the scales and leave the skin much 
smoother and softer. Medicated soaps should never be 
used except by the direction of a physician. 

Cleansing the Face. — The face should be well washed 



62 PERSONAL HYGIENE FOR WOMEN 

twice a day with cool or cold water, but the temperature 
of the water should not be below 60° F. The degree of 
coolness must be determined by the feelings and judg- 
ment of the individual. If the face were washed with very 
hot or very cold water, and then exposed to the cold air, 
the skin would become rough and chapped. The water 
should be soft. To soften hard water, put 1 pound of 
bran into a muslin bag, place in 4 quarts of water, and boil 
for fifteen minutes. Add enough of this bran water to the 
bath to make the water milky. 

A soft, woven face towel, kept for the face and neck 
only, should be used with a moderate degree of friction. 
Great care must be used to wipe the skin thoroughly 
dry. 

It is a question whether the daily use of soap on the 
face is advisable; for the healthy skin it is not essential 
and may prove very injurious. Soap should never be 
used on the face in winter just before going out-of-doors, 
as this would cause a roughening of the skin. When the 
hot tub-bath is taken, the face should be well washed with 
soap and hot water, plenty of friction being applied by 
means of the face towel, after which the face is thoroughly 
rinsed with pure water. This will open the pores of the 
skin, and should be followed by the use of cold water, 
which has a stimulant action on the blood-vessels and ' 
improves the circulation in the skin. It also improves the 
tone of the elastic fibers in the skin and tends to delay the 
appearance of wrinkles. 

If there is any tendency to dryness of the skin, a good 
cold cream should be well rubbed in just after bathing the 
face. The cream must be a good quality and perfectly 
fresh, as a rancid cream is irritating to the skin. Only 
so much of the cream should be applied as will be absorbed 
by the skin. When the skin is very thin, and there has 
been loss of subcutaneous fat due to ill health or other 
cause, the systematic application of cream in this manner 
aids in the nutrition of the skin; and, when applied to the 



THE CARE OF THE SKIN AND ITS APPENDAGES 63 

neck with good massage, is a great protection against sore 
throat due to exposure to drafts and cold. 

Protection of the Face. — The cold winds of winter 
cause a dryness of the uncovered skin of the face and lips, 
which often leads to a painful chapping, and, in the case 
of the lips, small fissures may be produced. In addition to 
the use of cold cream, a good rice powder may be applied, 
which serves as a further protection to the skin. 

In very cold weather a veil should be worn to protect the 
face from the cold and winds. In summer a parasol should 
always be carried, to protect the eyes and brain as well as 
the face from the hot rays of the sun. 

The Use of So-called Cosmetics for the Face. — 
All skin specialists, and these are in the very best position 
to judge of the great amount of harm that is done, say 
emphatically that the use of face lotions and "paints" 
can only work the lasting injury of the complexion. 
They may assist in hiding the defects of nature, but they 
frequently contribute to increase these defects. Many 
of them merely fill up the pores of the skin and give it a 
pasty look. Numerous cases of eczema and other dis- 
eases have followed the use of paints. Of the advertised 
cosmetics, many are not only worthless, but actually in- 
jurious. 

Certain applications to the skin of the face are permis- 
sible and beneficial. "Virgin milk," which is a milky- 
looking mixture, composed of the tincture of benzoin and 
rose-water, renders the skin soft, and is said to prevent the 
formation of freckles. If the skin is dry, glycerin may 
be added to this. The formula for this mixture is as 
follows : Take of the tincture of benzoin and glycerin each 
1 ounce, mix well, and then add 2 ounces of rose-water. 
This should be applied by the fingers, just after the face 
is washed. Pure glycerin is irritating, and should never 
be applied to the face without dilution. 

The various good preparations of rice and talcum pow- 
der on the market are perfectly harmless, and, if there is a 



64. PERSONAL HYGIENE FOR WOMEN 

tendency to greasiness or shininess of the skin, the use of 
these is essential from an esthetic point of view. In 
case of greasiness a little calcined magnesia may be used. 
In hot weather the use of face powder is very refreshing, 
and in the hot climates it is used for this purpose to a very 
striking extent. But the true cosmetics, and the only 
ones that can procure and keep a beautiful complexion, are 
plenty of exercise in the open air, attention to the diet, 
to the daily evacuation of the bowels, to the condition of 
the kidneys, to baths, and to proper dress. 

Facial Blemishes. — Among the most common facial 
blemishes are freckles, liver spots, a sallow complexion, 
pimples, acne, eczema, superfluous hairs, and wrinkles. 

Freckles. — These are brownish or yellowish pigmentary 
spots, varying from the size of a pin-head to that of a pea. 
They occur on the face and the backs of the hands. 
They consist of a circumscribed deposit of pigment; 
not much is known about their origin. The pigment is 
situated in the deep layers of the epidermis, and, in order 
to remove the freckles, it is necessary to use something 
capable of producing desquamation. As a rule, if left 
alone, they will gradually disappear. 

Liver Spots. — The so-called liver spots are irregular 
patches of a brownish color, which appear most frequently 
on the face, neck, chest, back, arms, and hands. If not 
caused by disorders of the liver and digestion, they are cer- 
tainly aggravated by them. They are not only unsightly 
blemishes on the skin, but sometimes cause great nervous- 
ness by the intense itching which accompanies them. 

Sallow Complexion. — This is generally caused by dis- 
orders of the liver, and is most frequently met with in hot 
countries. It is seen in chronic dyspeptics, and, indeed, 
in most forms of chronic disease, and is not only a symp- 
tom of the disordered bodily state, but a cause of its per- 
petuation. This appearance of the skin is due to the 
accumulation of effete matters in it and to its impaired 
nutrition, and this state exists not only in the skin, but in 
the whole body. 



THE CARE OF THE SKIN AND ITS APPENDAGES 65 

Pimples, or Blackheads, and Acne. — These are affections 
of youth, and are generally seen together, the last-named 
being simply a second stage of the first. Pimples, or 
blackheads, appear as small elevations in the skin, with a 
small black point in the center. The cause of the pimple 
is the alteration in the quality of the sebum, the oily 
secretion, which becomes and remains a hard mass in the 
excretory ducts of the sebaceous glands and plugs up its 
external opening. The dust of the air becomes mixed 
with the fat, and thus makes a black point. When the 
ducts cannot get rid of the sebum, they become stopped up, 
and in consequence become swollen. This irritation 
spreads to the adjacent tissues, and so inflammation arises. 
Finally, the contents of the duct undergo degeneration, 
suppuration occurs, and the contents become mixed with 
pus, small abscesses result at various depths in the skin, 
and so require more or less time to break out. 

This inflammatory condition of the sebaceous glands 
with their ducts is apt to become chronic and may 
prove an obstinate affection. It occurs most commonly 
about the face, on the back between the shoulders, or on 
the chest. The skin is rough to the touch, the ducts of the 
sebaceous glands are enlarged, and the skin is greasy. 

Eczema. — This is the most common of all skin affec- 
tions. It is a non-contagious, inflammatory disease of the 
skin, sometimes acute, but more often chronic, attended 
with itching and desquamation or loss of cuticle. With the 
itching may be a feeling of heat and tension in the part. 

Eczema is a local disease, brought about by a local 
irritation in the skin; but, in addition to this, there is 
generally a predisposing cause, as some disorders of the 
digestive tract, a bad condition of the blood, and so forth. 
The skin, like other organs of the body, depends on the 
whole system for its nutrition. When this nutrition is not 
sufficient, the skin appears pale, of a peculiar color, and is 
easily taken up in folds, an evidence of poor nutrition of 
the skin. When the skin is not properly nourished, 
every slight irritation is liable to produce eczema. 

5 



66! PERSONAL HYGIENE FOR WOMEN 

Treatment of Liver Spots, Sallow Complexion, 
Pimples, Acne, and Eczema. — First, the general treat- 
ment. While every case of skin disease must be treated 
according to the peculiarities of that patient's case, still, 
there are general rules which should be followed in the 
treatment of all cases, and first in importance comes at- 
tention to the bowels. There must be procured, by some 
means or other, a free daily evacuation. A hard, consti- 
pated movement is not sufficient. Fruits and vegetables 
are both laxatives and the very best. Water is also a 
laxative, and 3 pints a day should be taken, not only for 
the laxative effects, but also because this amount is needed 
to keep the kidneys properly flushed. Of the simple 
medicinal laxatives, one of the best is the effervescing 
granules of the phosphate of soda; the dose is from one 
teaspoonful to one tablespoonful, to be taken in a glass 
of cold water on rising in the morning. Sometimes pa- 
tients who are troubled with gas cannot take anything 
which effervesces; in that case, the plain phosphate of 
soda may be substituted. 

Next in importance to the attention to the bowels 
comes' the diet. All articles of diet must be easily di- 
gested, while at the same time they are nourishing. 
Cereals, pies, pastry, fried foods, hot breads, rich gravies, 
rich salads, pork, and veal must be excluded from the 
bill of fare. 

Fresh meat must be eaten by a woman in health at least 
once a day, and young girls need it twice a day. This 
should be supplemented with eggs and milk, fresh vege- 
tables, and not an excess of stale bread or toast. The 
latter is constipating. Tea and coffee should both be 
avoided. 

A glass of hot water, taken one hour before meals, 
will do much to rid the stomach of mucus and put it in a 
good condition for the digestion of the food. 

For the congestion of the liver, which is so often at the 
bottom of these disorders, it is generally necessary to 
consult a physician. 



THE CARE OF THE SKIN AND ITS APPENDAGES 67 

Pure air, associated with the proper kinds of exercise, 
promotes the functions of the skin, assists in keeping the 
blood in good condition, increases the vigor, keeps the com- 
plexion clear and increases its beauty; while, on the other 
hand, a sedentary life in a confined air produces a pallid and 
frequently a blotched skin, with headache and dyspepsia. 

Steaming the Face. — It seems that the blood-vessels of 
the skin are much better able to absorb vapor than water. 
The vapor penetrates and softens the epidermis much 
better than the simple application of water would. The 
increased secretion from the skin which is thus caused 
is beneficial. After using the vapor bath the outer layers 
of the epidermis peel off and the complexion is improved 
by the substitution of new pigment. The absorption of 
the moisture also causes a roundness of the skin and a 
filling out of the wrinkles. Generally, vapor baths can 
be used in those cases of skin diseases where the skin is 
rough and dry. Next in importance to the vapor bath 
is steaming the face. Bathing the face with very hot 
water is also recommended. 

Massage of the Skin. — Where the complexion is sallow, 
or there is a tendency to pimples or blotches, massage of 
the skin of the face will do much to improve the circulation. 

The massage is most effective when it follows steaming 
or washing the face in hot water. The tips of the fingers 
should be dipped in cold cream, and then, pressure being 
exerted by them, the skin of the forehead should be 
deeply stroked from the middle line out over the temples. 
The nose should be stroked from the bridge outward and 
downward. The skin of the cheeks should be pinched up 
and rolled between the fingers and thumb. All these 
movements facilitate the emptying of the follicles. 

Never use an ointment on the face that contains vaselin 
or lanolin, but particularly the former, as they are both 
apt to produce a growth of hair, but these preparations 
are excellent to increase the growth of the eyebrows. 

Wrinkles. — In very many cases wrinkles are the result 
of habit of expression, as in scowling; or an expression of 



68 PERSONAL HYGIENE FOR WOMEN 

dejection, when the angles of the mouth curve downward, 
and so forth. 

There are twenty-eight muscles about the mouth. 
Since all these muscles are developed by use, the mouth 
comes to assume the expression given to it by the thoughts 
of the individual. The figurative expression, " down at 
the mouth/ ' comes to be literally true, and the angles of 
the mouth are seen to be habitually drooping, until at 
last this is the fixed expression of the face. A healthy 
frame of mind is the only means to keep the face from 




Fig. 3. — Muscles of the right side of the head and neck. 

being converted into a map of wrinkles and drooping 
angles at the mouth. 

The wrinkles are not, as a rule, caused by any trouble 
in the skin itself, but in the underlying muscles, the 
tissues of which have become relaxed or weakened. The 
circulation of the parts may be stimulated, and so in- 
creased nourishment be secured by deep massage of the 
muscles, and, at the same time, the use of a good cold 
cream will aid in the nourishment of the skin. 

The face should first be washed and steamed according 
to the directions already given. The massage of the face 



THE CARE OF THE SKIN AND ITS APPENDAGES 69 

should always be carried out in a systematic manner. 
Begin with the forehead. Stroke with the two thumbs 
over the forehead, starting near the eyebrows, and work 
out toward the roots of the hair. In the second move- 
ment one hand is used to stretch the part worked upon, 
while deep friction is made with the tips of the ringers of 
the other hand. 

For wrinkles about the eyes, stroke with the tips of the 
ringers, over and below the eyes, from the nose toward the 
temples. Great care must be taken not to apply too much 
cold cream about the eyes, lest some of it should get into 
them. For the removal of the " crow's feet " at the outer 
angle of the eye stretch the part with the thumb and finger 
of one hand, and perform friction with the tips of the fingers 
of the other hand. 

To remove the lines that run from the corners of the nose 
to the angles of the mouth, stroke with both hands, one on 
each side of the face, beginning at the center and lower 
part, and stroke upward toward the temples. This up- 
ward motion counteracts the drawn and pulled-down 
condition of the face. 

For the cheeks, use both friction and deep kneading; 
pick up the muscles between the thumb and finger. 

To remove wrinkles under the chin and a double chin, 
begin at the middle line, and with both hands make deep 
pressure upward and outward. To remove superfluous 
fat, make deep friction with the tips of the ringers. In 
the latter case, only use enough cocoa-butter on the 
fingers to prevent the friction against the skin. The 
benzoin preparations, already given, will help to contract 
the tissues. 

A cold cream which is a good skin food is the follow- 
ing: Take of the oil of sweet almonds, 2 ounces; of sper- 
maceti, J ounce ; of white wax, J ounce ; and of rose-water, 
\ ounce. Melt together at a moderate heat, the oil, 
spermaceti, and wax, then gradually add the rose-water; 
stir the mixture briskly and constantly until it is cool, 
and continue the stirring until it has become uniformly 



70 PERSONAL HYGIENE FOR WOMEN 

soft and creamy. The Dover egg-beater will give it the 
desired creamy appearance. 

The Hair. — From an esthetic point of view, a head of 
luxuriant hair is a matter of prime importance to the 
woman. 

The hairs are peculiar modifications of the epidermis. 
The hair follicle is a cylindric-shaped depression of the 
skin, whose funnel-shaped mouth opens on the free sur- 
face. Immediately below this is a constriction, called the 
neck, which is the narrowest part of the follicle; the duct 
of the sebaceous gland, which supplies the hair with oil, 
opens at this point. The base of the follicle is bulb-shaped, 
to accommodate the hair-papilla and the hair-bulb. The 
hair-papilla contains the blood and nerve supply for the 
hair. When a hair is plucked or falls out, a new hair grows 
from the hair-papilla. 

According to Pincus, the life of a hair ranges from two 
to six years, after which it falls out, to be replaced by a 
new one. In this way about fifty or sixty hairs are nor- 
mally shed every day. 

In order to have thick, luxuriant, silky hair great atten- 
tion must be paid to the condition of the scalp, since it is 
the scalp which contains the blood-vessels that nourish 
the hair. The scalp should be thick and pliable and move 
freely over the bones of the skull. If the scalp is drawn 
tightly over the bones of the skull, it tends to constrict 
the blood-vessels, and so lessen the supply of blood to the 
scalp and cause atrophy of the roots of the hair from pres- 
sure. 

The hair has a great tendency to accumulate dirt. It 
catches the dust flying in the air, and also retains the secre- 
tion of fat and the desquamated epithelium of the scalp 
and the products of perspiration. 

The two chief causes of the premature thinness of the 
hair are a deficient circulation of blood in the scalp and 
dandruff, and it is said that dandruff causes the loss of 
hair in 70 per cent, of all cases. 

Dandruff. — The last few years has witnessed a revolu- 



THE CARE OF THE SKIN AND ITS APPENDAGES 71 

tion in the views of the skin specialists in regard to the 
cause of dandruff. Previous to that time it was consid- 
ered as simply a collection of epithelial scales mixed with 
more or less oily matter. Now, following the investiga- 
tions that were first instituted by Unna, dandruff is con- 
sidered as a symptom of a parasitic disease of the scalp, 
called seborrheic eczema. Sabouraud believes that the 
same parasite that produces seborrhea causes the loss of 
hair. It is believed that the parasite grows down into the 
hair follicle, between its walls and the hair. 

Seborrheic eczema is a chronic desquamative inflam- 
mation of the scalp of bacterial origin. It is divided into 
two stages: the first may last from one to seven years; it 
is attended with more or less dandruff in the form of scales 
and dryness of the hair; or the dandruff may unite with 
the oil, producing fatty crusts which are removed with 
difficulty. This is followed by the second stage, in which 
the hair falls out. 

Symptoms of Seborrheic Eczema. — In the dry form of the 
disease, in which there is a scaling of the scalp, the hair is 
dry and unmanageable, the head itches, especially when 
the patient sits under a light or becomes overheated. 
There is a more or less constant falling of the scales upon 
the clothes. The scalp looks pale, and will be found 
covered with fine grayish or yellowish, readily detachable 
scales. Sometimes there is more or less redness of the 
scalp. This is the mildest grade of the disease. 

That dandruff is contagious has been proved by experi- 
ment, experience, and treatment. Lassar and Bishop 
made a pomade of the scales taken from the head of a 
student who was suffering from this disease, and rubbed it 
into the backs of guinea-pigs, which caused the same dis- 
ease in them, and falling out of the hair. 

Cases have been reported in which husband and wife 
have contracted dandruff after marriage, he or she having 
been free before. 

The drugs that are most efficacious in the cure of 
seborrhea are active antiparasitics. 



72 PERSONAL HYGIENE FOR WOMEN 

Causes of Seborrheic Eczema. — The general causes are 
debility, constipation, and anything which undermines the 
general health. The local causes are lack of cleanliness of 
the scalp, and using combs or hair-brushes which have 
been used on the scalps of persons who were suffering 
from this disease. 

In most families will be found one or more mem- 
bers who possess enough seborrheic infection to cause 
the spread of the disease throughout the rest of the 
household. 

Causes and Treatment of Premature Thinness of 
the Hair and Baldness. — It has already been stated that 
70 per cent, of these cases were caused by seborrheic 
eczema. Among other causes may be mentioned a pro- 
gressive tightening of the scalp upon the skull, the scalp 
having lost the cushion of fat that is under it in early life; 
insufficient or improper care of the scalp ; daily sousing of 
the head in cold water, combined with improper drying 
of the hair afterward; sweating of the head; constant 
mental strain, either on account of intellectual work or 
worry; wearing stiff, unyielding hats; gout, and all diseases 
which lower the general nutrition. 

The chief treatment is by prophylaxis, or using pre- 
ventive measures to insure the healthy condition of the 
scalp. And first and most important of these is cleanli- 
ness. Because of the great length of time which it takes 
to dry long, thick hair, many women do not wash the scalp 
often enough. In the healthy state of the scalp it should 
be washed at least once a month. 

The Care of the Hair. — There is never any danger of 
shampooing the healthy scalp too frequently. The oil in 
the scalp is not removed by washing, but is, on the con- 
trary, always increased through the improvement in the 
circulation. Where there is much dandruff, or if the hair 
has begun to fall out prematurely, owing to long neglect 
or following an illness, it is well to begin by washing the 
hair two or three times a week, and then gradually in- 
crease the interval to every two or three weeks. 



THE CARE OF THE SKIN AND ITS APPENDAGES 73 

Borax in the water cleanses the scalp well, but its con- 
tinuous use is injurious; the same may be said of am- 
monia water. 

One of the best shampoos is the tincture of green soap. 
If this cannot be obtained, take of the official green soap 
2 ounces, and of alcohol, 1 ounce; mix well, and make 
shampoo. One ounce of the tincture or its substitute 
should be diluted with twice as much water and applied 
to the scalp with the tips of the fingers. When enough of 
the shampoo has been used, add sufficient water to make 
a good lather. This must be thoroughly rubbed into the 
scalp, going over the whole systematically. After the 
scalp is cleansed, the soap must be well rinsed out of 
the hair. This may require many changes of the water, 
but it is most important. Dry the hair with hot towels, 
the process being completed by a radiator or stove oven. 
Fanning the hair will hasten the process very consider- 
ably. The hair should then be loosely braided and a hot 
towel wound around the head to insure perfect dryness 
of the hair and as a prevention against taking cold. 
One hour is sufficient for the entire procedure. In winter 
the hair should be washed just before retiring. 

Brushing the Hair. — Brushing increases the growth of 
the hair by stimulating the circulation in the scalp and by 
removing the dandruff. To be effective, the hair should 
be well brushed at least once a day, when there must be a 
deep brushing of the entire scalp. The bristles of the 
brush must be stiff enough to warm, but not to scratch, 
the scalp. Brushing and massage remove any loose hairs 
that are ready to fall, but they will soon be replaced by 
new vigorous ones. 

Combing simply disentangles the hair. The teeth of 
the comb must be far apart and have rounded ends. In 
no case should a fine-toothed comb be used. It tears out 
the hair, and often causes an irritation of the scalp which 
leads to disease. 

From what has been said, it will be seen that every 
member of the family should have a brush and comb for 



74 PERSONAL HYGIENE FOR WOMEN 

her own exclusive use, and that no one should allow a 
public brush or comb to be used on her head. 

The brush and comb must be washed once a week in 
water containing a little ammonia; they must be well 
rinsed out in pure water; the brush should be dried 
quickly, with the bristles down. If the brush and comb 
are not cleaned sufficiently often, the scales of dandruff 
would be sufficient to reinfect the scalp. 

Massage of the Scalp. — The scalp should be thoroughly 
massaged every night. Grasp the scalp with both hands 
laterally, as well as anteroposteriorly, and with some press- 
ure loosen the tissues from the underlying parts and try 
to raise it in folds, or it may be pinched with the forefingers, 
producing some vascular flux and a sense of warmth. 

If the scalp is too dry, nothing is better than pure 
vaselin, though some persons prefer olive oil, applied by 
means of a dropper. The yolks of eggs beaten up with 
lime-water make an elegant shampoo. 

Dressing the Hair. — Dragging or twisting the hair from 
its natural direction, pulling it into constrained or arti- 
ficial positions, and even twisting the hair very tightly 
is injurious to it. 

The curling iron acts by abstracting more moisture on 
one side of the hair than on the other. The stronger the 
hair, the more easily it will curl, and the longer it will stay 
curled. The daily use of a hot iron, notwithstanding 
the greatest care, will in a short time prove injurious; 
the hair is apt to become thin and fall out. Its growth 
is interfered with. The use of kid curlers is much less 
injurious, but even here the tight twisting of the hair 
around the kids is said to be harmful. 

Shell hair-pins are the best for the hair. If steel ones 
are used, the points must be smooth and the pins kept 
in good condition. 

When the hair is dressed for the night, after the scalp 
has been brushed and massaged, it should be loosely 
braided and left hanging down„ 

Cutting the hair 1 inch, every two or three months, is 



THE CARE OF THE SKIN AND ITS APPENDAGES 75 

said to promote the growth of the hair and prevent its 
splitting. It does not increase the number of hairs. 

There is no truth in the assertion that the hair is a hol- 
low tube, which allows the escape of oil, and that if the 
ends are sealed by singeing much good will result. 

Gray Hair. — Grayness of the hair may be either 
premature or physiologic. When the grayness is due to 
some temporary cause, as anxiety or some diseased state, 
the process may cease completely on the removal of the 
cause. Usually the whitening is permanent. The gray- 
ness of the hair is caused by obscure changes in the 
nutrition of the hair-papilla, which interfere with the 
production of the pigment. As a rule, the hair whitens 
first on the temples, then on the top of the head. 

The hair first turns gray at its root. The grayness is 
due to the loss of pigment. Prolonged residence in either 
a very cold or a very hot climate will cause the hair to 
turn gray. 

A yellowish tinge of the hair is sometimes seen in pa- 
tients with jaundice, or gray hair may owe its dull yellow 
color to the tint of dry albumin of which it is composed. 
The glitter of steel-gray or silver-white hair is due to the 
high refractive power of the minute air-bubbles that lie 
in the substance of the hair. 

Treatment — The color cannot be restored to gray hair. 
The roots of the hair are embedded in the hair follicles, 
and cannot be reached by any fluids applied to the scalp. 
Not only is the use of hair-dyes to be deprecated as an 
exhibition of poor taste, which happily is going out of 
fashion, but the use of hair-dyes is extremely dangerous. 
Cases are being constantly reported by physicians, where 
the use of these supposedly simple vegetable hair-dyes 
has been followed by very serious and extensive derma- 
titis of the face, neck, and shoulders. 

Gray hair is really very beautiful when it is of silvery 
whiteness, and very ugly when it is of a yellowish-white 
color. It must be treated with much greater care, in 



76 PERSONAL HYGIENE FOR WOMEN 

order to preserve its silvery whiteness, than was neces- 
sary to keep the hair in good condition before it lost its 
coloring pigment. It should never be wet, except when 
it is shampooed. For this reason, instead of using hair- 
curlers, crimping pins should be used. In this way the 
hair is waved quite as well and the use of water is avoided. 

The Cosmetic Care and Treatment of the Hands. — 
Of all the members of the body, next to the face, the 
hands have the most expression, and serve as an index 
of character and refinement. 

Not only should the most scrupulous attention be given 
to having clean hands and nails, but every precaution 
should be taken to keep the skin soft and the nails care- 
fully manicured. This is quite possible for the housewife, 
simply by wearing rubber gloves while she does her work. 
It preserves the fine sense of touch in the fingers, which aids 
in sewing and embroidery, at the same time that it adds 
much to the beauty of the hands. 

Chapped Hands. — To prevent chapping of the hands 
in cold weather heavy gloves must be worn or a muff 
carried. Another aid in the prevention of the skin of the 
hands from becoming rough and chapped, and the best 
means for curing them if this has occurred, is by the 
use of a good cold cream at night, just before retiring. 
The cold cream should be well rubbed in the skin, espe- 
cially about the finger-nails, and after this talcum powder 
be dusted over. This forms a thick covering for the hands, 
the talcum powder prevents the cream from being rubbed 
off on the bed-clothes, and, on getting up in the morning, 
the skin will be found to be soft. Only in case the hands 
are very badly chapped should old kid gloves be worn at 
night. 

Cosmetic of the Nails.— The physiologic function of the 
nails is to protect the tips of the fingers against pressure 
and to give them a firm support ; this increases the delicacy 
of the tactile sensations. 

The nails should be slightly curved from side to side, of 



THE CARE OF THE SKIN AND ITS APPENDAGES 77 

a light rose color, and smooth surface. The lunula should 
be visible at the root of the nail. Brittleness of the nails 
is a defect, which causes them to tear easily; it is generally 
due to the condition of the general health. 

There is a natural tendency for the dirt to accumulate 
on the under surface of the nail, between it and the finger. 
This is not only unsightly, but it is often the cause of 
actual danger, as this forms a lodgment for the germs of 
disease. Not only is it necessary for doctors and nurses 
to give the most scrupulous attention to the care of the 
nails, but, when we learn that one cook has been the cause 
of spreading typhoid fever through a number of families, 
in her itinerary in going from place to place, we must be 
impressed with the necessity of more careful oversight 
being given to the hands of domestics and housewives 
who prepare the food. 

For the same reason, it is self-evident that the hands 
should always be washed immediately before going to the 
table, and cleaning the nails is always a finishing touch in 
the washing of the hands. 

For the purpose of cleansing the nails, an orange stick 
or nail-file should be used, and never the point of the scis- 
sors or the blade of a knife, for either of these causes a 
roughening of the under surface of the nails, whereby 
the lodgment of dirt becomes only the more securely 
fixed. After the use of the nail-file, the nail-brush should 
be used, followed again by the use of the file or stick. 
If there is a tendency to a roughening of the skin under 
the nail, it can be obviated by the use of cold cream at 
night. Just before retiring, the fingers should be dipped 
into cold cream, and let the tips take up just as much as 
they will retain, and after this dipped into talcum powder. 

The small rim of epidermis which laps over the nail 
should be gently shoved back with the orange stick every 
day. This skin, when torn, forms the so-called hang- 
nails, by which infection easily enters the system; it 
may give rise to felons or even to general blood-poison- 
ing. 



78 PERSONAL HYGIENE FOR WOMEN 

The Care of the Feet. — In the care of the feet it must 
be remembered that the leather of the closely fitting boot 
allows very little ventilation, and so more attention must 
be paid to the airing of the feet as well as to their bathing. 
The feet should be bathed twice daily. 

On making the toilet for the evening dinner both shoes 
and stockings should be changed, the stockings hung up in 
the room, and the shoes left out to air and dry, instead of 
being stuffed into the shoe-bag, to remain there until 
the next morning. 

An alcohol rub will be found very refreshing to weary 
feet. For profuse perspiration of the feet, boric acid or 
talcum powder may be used, dusting the powder over the 
feet both night and morning. 

Ingrowing Toe-nails. — The common causes of ingrowing 
toe-nails are improper foot-wear and an improper method 
of cutting the nails. If the nail is cut too short, especially 
at the angles, while at the same time the shoe is too short 
or too narrow, the skin of the toe is forced over the nail, 
so that it necessarily happens that, by the further growth 
of the nail, the flesh of the toe is pushed still further over, 
until a point is reached where inflammation is set up. 
There is excruciating pain, which may be accompanied by 
the formation of a small tumor, which forms pus and may 
go on to granulation — the so-called " proud flesh/' 

The preventive measures of the trouble are, first, in 
cutting of the nails. The toe-nail should be cut in a con- 
cave form, the outer angle projecting beyond the toe. 
If there is a tendency for the flesh to grow over the nail, 
the flesh should be pushed back from the nail, and fast- 
ened in this position with a strip of oxid of zinc plaster, 
and a gauze packing should be inserted under the nail- 
edge. A saturated solution of boric acid serves as an 
antiseptic dressing. It is often possible to cut off the 
projecting nail, and, by the use of the boric acid dressing, 
the trouble disappears in a few days. Attention should 
always be given to the toe-nails when bathing. 

Corns. — There are two varieties of corns; both are very 



THE CARE OF THE SKIN AND ITS APPENDAGES 79 

painful. Soft corns come between the toes, and unless 
absorbent cotton is inserted to prevent the rubbing of the 
toes together, a second corn appears on the opposing sur- 
face of the adjoining toe. A very effective remedy for 
this is the application of blue-stone, or sulphate of copper, 
to the corn. The stone is moistened in water and then 
applied thoroughly to the corn; absorbent cotton should be 
placed between the toes. In very severe cases it may be 
necessary to stay off the feet for a few days and keep the 
foot upon a chair. 

Hard corns must be cut down with the greatest care. 
It should be done directly after the bath, so as to have the 
skin in as nearly an aseptic condition as possible. A small 
scalpel, composed entirely of steel, should be kept for this 
purpose. It must be thoroughly cleaned after it is used, 
and just before its use be sterilized by boiling for five 
minutes. The reasons for these precautions are the pos- 
sibility of cutting into the flesh and setting up blood- 
poisoning by the entrance of germs into the wound. 



CHAPTER IV 

THE DIGESTIVE SYSTEM: GENERAL PRINCIPLES 
IN HUMAN NUTRITION AND DIETETICS 

The Digestive Tract; Care of the Mouth and Teeth; Controlling 
Factors of Digestion; Psychic Aspect of Digestion; Importance of 
Mechanical Factors; Chemical Changes of Food in the Stomach; 
Intestinal Digestion; Metabolism; Constipation and its Treatment. 

The Amount of Food Required; the Classification of Foods; 
Standard Dietaries; Maintenance Diet; Relations of Diet to Various 
Conditions of Life; Practical Facts for Guidance; Dietary in the 
Tropics; Food Economics; Table of Food Values. 

The Physiologic Action of Moderate Doses of Alcohol; the Effect 
of Alcohol on the Muscular System; the Effect of Alcohol on the 
Nervous System. 

"If there is anything new of importance in the practice of medicine 
it is this modern work in nutrition." — Mendel, 1914. 

The activities of animals are carried on by a certain 
expenditure of energy which is set free as the result of a 
chemical breaking down of the living tissues of the body. 
In order to maintain the equilibrium of the body this 
waste must be replaced by new material which is taken in 
the shape of food, drink, and oxygen. 

Digestion is the term applied to those changes in the 
food-stuffs which precede absorption; it is a refining process 
which separates the useless from the useful, and further 
prepares the latter to be used as building-stones for the 
repair of organs and tissues and to furnish fuel to supply 
the motor energy of the body. 

In the human body the digestive processes are brought 
about by mechanical disintegration; by the action on the 
food-stuffs of acid and alkaline fluids; by changes produced 
by active substances called enzymes; and, lastly, decom- 
position is produced by the growth of microorganisms. 

The digestive tract, or alimentary canal, begins at the 

80 



THE DIGESTIVE SYSTEM 



81 



mouth and ends at the anus. It consists of the mouth, 
the esophagus or gullet, the stomach, the small and large 
intestines. Two large glands, the liver and pancreas, 



Large intes 
tine 



Salivary 
(parotid) gland 




Rectum 



Vermiform appendix 

Fig. 4. — General scheme of the digestive tract, with the chief glands 
opening into it (Stockton). 



pour their secretions into the small intestine to aid in the 
digestion of foods. The alimentary canal, liver, and pan- 
creas together constitute the digestive system. 

6 



82 PERSONAL HYGIENE FOR WOMEN 

The contraction of the muscular walls of the digestive 
tract is the propelling power that carries the food down- 
ward and brings it into contact with the digestive fluids. 
These movements will be referred to later, under the 
Mechanics of Digestion. 

The digestive tract is lined throughout its entire course 
by mucous membrane; that lining the mouth gives some 
idea of its character. It is from the mucous membrane 
lining the stomach and intestines, as well as from the liver 
and pancreas, that the digestive fluids are poured forth 
into its cavity. 

In passing downward the food meets with five different 
digestive fluids: the saliva in the mouth; the gastric juice 
in the stomach; and the bile, pancreatic, and intestinal 
juices in the small intestine. Each digestive fluid acts 
only on some particular kinds of food. This action of the 
digestive fluids on food is called the chemical part of 
digestion. 

The Care of the Mouth and Teeth. — It is of the first 
importance that the mouth should be kept clean and as 
nearly aseptic as possible, for as the food is rolled about 
in the mouth by the process of mastication it is obvious 
that it will carry all the germs and mucus with it into the 
stomach. A nasal spray containing some solution of an 
alkaline or antiseptic nature should form an essential part 
of the toilet of the mouth. 

The Teeth. — From simply an esthetic point of view well- 
kept teeth are beautiful and greatly enhance the charm of 
the face. But the proper care of the teeth is also essential 
to good digestion and good health. 

In perhaps the majority of people the teeth are suffi- 
ciently far apart for small particles of food to become 
lodged between them. If not promptly removed, the heat 
and moisture of the mouth, acting on these small particles, 
cause their decomposition and set up acid fermentation in 
the mouth; and it is this acid which causes the decay of the 
enamel and finally of the teeth. The decayed tooth gives 
still further lodgment to particles of food, and these, left 



THE DIGESTIVE SYSTEM 83 

to decompose, give rise to the most offensive gases, giving 
fetor to the breath, poisons the blood, and so injures the 
digestive and nervous systems. 

Where possible a tooth-pick and dental floss should be 
used immediately after each meal; the waxed dental floss 
between the teeth, and the flat end of the tooth-pick to 
remove any particles that may have worked in about the 
roots of the teeth and gums. 

A tooth-brush with good tooth-powder should be used 
twice a day. The brush should not be too broad, and is 
better if slightly curved. The bristles should not be too 
hard. The use of tooth-powder, which must be very fine, 
or tooth-paste is needed to produce sufficient friction to 
clean the teeth well. Warm water is a better solvent than 
cold, and, therefore, it is well to use it for cleansing the 
teeth. 

While it is generally known that decay if neglected will 
destroy a tooth, it is not so well known that many teeth are 
lost as the result of the accumulation of tartar at the gum 
margin. There is a great tendency to this, especially about 
the necks of the lower incisors and upon the teeth that are 
not used in chewing. The deposit of tartar encroaches 
upon the neck of the tooth and presses upon the gum; the 
latter becomes irritated or inflamed, and recedes from the 
tooth; malnutrition and loosening of the tooth follows. 

With very imperfect or decayed teeth proper mastica- 
tion is impossible. 

The teeth should be examined by a good dentist twice a 
year, so that small cavities shall be discovered at an early 
stage, the tartar removed, and the teeth kept in their best 
condition. This will prevent the early loss of the teeth. 
Lost teeth must be replaced, so that the teeth shall be op- 
posite each other, for a very important factor in masti- 
cation is that the teeth shall strike properly. 

Digestion. — The factors controlling digestion are psychic, 
mechanical, and chemical. 

Briefly stated, the process of digestion consists first in 
the liquefaction of the solid portions of food and the con- 



84 



PERSONAL HYGIENE FOR WOMEN 



version of the insoluble into soluble and diffusible, for no 
nutriment can be assimilated until reduced to a state in 
which it can pass through a cell membrane. These 
chemical changes are carried on by a series of enzymes. 




Fig. 5. — Location of the viscera of the body and their relation 
to each other: D, D, Lungs with air expelled; E, E, diaphragm 
cut away to show, F, liver cut to show stomach; 2, gall-bladder; 
H, H, large intestine; K, small intestine; L, vermiform appendix 
(after Heath). 



Enzymes are unorganized ferments which possess the 
power of producing chemical changes in certain substances 
with which they come in contact under particular condi- 



THE DIGESTIVE SYSTEM 85 

tions without themselves suffering permanent alteration. 
The digestion of food is largely accomplished by the 
specific action of these enzyme bodies, of which every di- 
gestive fluid contains one or more. 

But neither solubility nor diffusibility is adequate. 
Freely soluble substances like cane-sugar need to undergo 
digestive changes just as definite as those carried out in 
the case of fats or coagulated proteins. The changes 
which they undergo before absorption serve a more fun- 
damental purpose than the mere hastening of their passage 
through the lining membrane of the intestine. 

In the light of modern chemical knowledge we can be 
somewhat specific in regard to the molecular aspects of the 
digestive processes. They are probably always cleavages, 
large molecules giving rise to smaller ones. When the 
original molecule is of extraordinary size, as with proteins 
and starches, these cleavages have a serial character, and a 
number of intermediary products must accordingly be 
formed; that is to say, the earlier products are in turn 
subjected to digestion. Such cleavages are generally, if 
not always, hydrolytic ; that is, water enters into the reac- 
tion and its elements are found combined in the products. 

The Psychic Aspect or the Effect of the Emotions on 
Digestion. — The relation of the emotions to the activities 
of the alimentary canal are of very practical importance, 
because recent investigations have shown that not only 
are the first stages of the digestive processes normally 
started by the pleasurable smell, sight, and taste of food, 
but also the pouring out of the gastric juice. 

The importance of the initial psychic secretion of the 
saliva for further digestion is indicated when we realize 
that materials can be tasted only when dissolved in the 
mouth, and thereby brought into relation with the taste 
organs. The saliva which waters the mouth assures the 
dissolving of the dry but soluble food even when it is taken 
in large amounts. 

The importance of the initial psychic secretion of gastric 
juice is made clear by the fact that the continued flow of 



86 PERSONAL HYGIENE FOR WOMEN 

this juice during digestion not only stimulates the glands 
of the stomach to pour out the chemical gastric juice, but 
by its action on the mucous membrane of the duodenum 
it also starts the flow of bile and pancreatic juice. 

These facts are of fundamental importance in the cooking 
and serving of food, especially when the appetite is fickle. 
A bright and cheery dining-room, the daintiness of the 
table service, the center-piece of ferns or flowers, all are 
factors in exciting the pleasurable emotions, and so stimu- 
late the appetite. 

On the other hand, the digestive processes may be wholly 
abolished by vexation, worry, and anxiety, or when such 
strong emotions as anger or fear are allowed to prevail. 
This fact has long been known in regard to the salivary 
secretion, and it has now been established in regard to the 
secretion of the gastric juice. It is necessary to avoid all 
circumstances likely to provoke emotional reactions. 

The inhibitory influence of excitement on the flow of the 
gastric juice has been studied by Professor Cannon, of 
Harvard University, in an interesting series of experiments 
on dogs. And a most important point is that the cat, 
which was allowed to infuriate the dog being experimented 
on, was only in the room for five minutes, and in spite of 
the fact that the animal was hungry and ate eagerly; there 
was almost a complete suppression of the flow of gastric 
juice for a period of twenty minutes. 

A similar experiment was tried on a boy with a gastric 
fistula. Food was shown to the boy and then withheld. 
He was so vexed because he could not eat at once that he 
began to cry and flew into a towering passion, with the 
result that no secretion appeared even after the child was 
calmed. In both the case of the dog and boy there was 
not only a temporary inhibition of the flow of gastric juice, 
but it is a noteworthy fact that the effects of the emotional 
excitement remained long after its cause had been re- 
moved. 

The practical point is, that if the digestive processes 
have been inhibited by emotional disturbances any food 



THE DIGESTIVE SYSTEM 87 

taken will lie stagnant in the stomach; and not only will 
there be a suppression of the gastric but of the pancreatic 
secretion as well, with the consequence that there is likely 
to be an accumulation of unabsorbed organic material in 
the colon and perhaps higher up as well. Bacterial decom- 
position will be fostered and actual harm may be done the 
organism. 

And just as a single occasion may lead to a passing diges- 
tive disturbance, so continual mental depression, worry, or 
grief may permanently impair the working of the tract and 
so undermine the vigor and capacity of the sufferer. 

It is believed that many acute attacks of indigestion in 
children are due to sharp rebukes administered at the 
table. 

The Psychic Tone. — Just as there is a psychic secretion, 
so likewise there is a "psychic tone," or psychic contraction 
of the gastro-intestinal muscles, as a result of taking food. 
And just as the secretory activities of the stomach are in- 
hibited by strong emotions, so also are the movements of 
the stomach. And, indeed, the movements of nearly the 
entire alimentary canal are almost completely stopped 
during moments of great excitement. 

The condition of mental discord may thus give rise to a 
sense of gastric inertia, so that anxiety may be accom- 
panied by a feeling of weight as if the food remained in the 
stomach, and every addition of food causes an increase of 
the distress. 

The Importance of the Mechanical Factor in Digestion. 
— The mechanical reduction of food in the alimentary 
canal is preliminary to its actual digestion. The first stage 
of digestion takes place in the mouth, and this is the only 
portion of the digestive canal which is under the control of 
the will. It is here that the food is ground into fine par^ 
tides by the act of mastication, and the more thoroughly 
the food is pulverized in the mouth, the more rapidly and 
easily can it be acted on by the gastric juice, and the 
very act of chewing increases the flow of saliva as well as 
shortens the time that the food will remain in the stomach. 



88 



PERSONAL HYGIENE FOR WOMEN 



The saliva not only protects the mucous membrane of the 
mouth, but it keeps it free from small food particles, which 
if allowed to remain would decompose, and thus injure 
the teeth by the action upon them by the acids produced. 







Fig. 6. — The ribs removed, showing relation of thoracic to ab- 
dominal viscera: A, Trachea; B, heart; C, C, lungs; D liver; E, 
stomach; F, small intestine; G, large intestine; H, bladder (after 



It also moistens the dry food, aids in the process of swal- 
lowing, and has some action on the starchy substances of 
the food. By the process of mastication, then, the food 
is divided into small particles and thoroughly admixed 



THE DIGESTIVE SYSTEM 89 

with the saliva until the whole is converted into a fine 
pulp. 

Besides favoring the mechanical part of digestion and its 
slight chemical action on starchy foods, saliva, being an 
alkaline fluid, is a distinct stimulation to the secretion of 
gastric juice. After the food has been reduced into a pulp 
in the mouth, and the change of starches into sugar has 
begun, it is swallowed and passes into the next compart- 
ment of the digestive apparatus, namely, the stomach. 

The stomach may be felt at the lower extremity of the 
breast bone, in the triangular space formed by the diverg- 
ence of the ribs. It is a large hollow, compound gland, the 
walls of which contain muscular fibers in addition to the 
tubules which elaborate the special secretions. Its cavity 
is lined with a thick mucous membrane, packed with 
tubular glands, into which is poured out a complex secre- 
tion called the gastric juice. 

The Chemical Changes which Food Undergoes in the 
Stomach. — There are two chief phases or periods of gastric 
secretion: (a) The psychic or appetite juice, and (6) the 
chemical juice. Gastric juice is not constantly poured into 
the stomach to accumulate there, but is secreted only as it 
is needed under the influence of certain stimuli. These 
stimuli may be classified as psychic and chemical. 

In the second phase, or period of gastric digestion, the 
exciting agent is the presence of food in the stomach. It 
has been shown that a correlation of the different organs of 
the body is brought about by hormones or chemical mes- 
sengers. The hormones of gastric digestion are produced 
from proteins in the early stage of gastric digestion, and 
this shows the importance of the psychic or appetite juice. 
A similar effect is produced by meat extracts or infusions, 
which are well-known provocatives of gastric secretion. 

Gastric Juice. — The principal active agents of the gastric 
juice are hydrochloric acid and the enzymes; pepsin, the 
proteolytic enzyme; rennin, the milk-curdling ferment; 
and lipase, the fat-splitting ferment. The uses of the gas- 
tric juice are digestive, activating, and disinfecting. 



90 PERSONAL HYGIENE FOR WOMEN 

Gastric juice does not dissolve and chemically change 
all food that enters the stomach, but acts only on that 
class of foods called proteins, converting them into pep- 
tones. 

The changes which food undergoes in the stomach are as 
follows: food is disintegrated; meat is broken up, gelatin 
dissolved; the muscle-fibers fall apart, and are split into 
disks and sarcous elements; the framework of fatty tissue 
undergoes similar dissolution of cellular membranes; milk 
is curdled; the caseinogen is transformed into casein, and 
the latter broken down by pepsin. Bread and other 
starchy foods are disintegrated, some of the starch being 
formed into sugar by ptyalin. The other vegetable foods 
are but little digested by this viscus. The whole is broken 
into irregular fragments by the disintegrating power of 
the stomach and gradually converted into chyme, the 
creamy emulsion which passes through the pylorus into 
the intestines. The passage from the stomach into the 
duodenum is aided by the motor activity of this organ. 

The Mechanics of Digestion in the Stomach. — Recent in- 
vestigations, especially those of Cannon, have thrown 
much light on this subject. The food introduced into the 
stomach from the esophagus is lodged first in the fundus or 
cardiac end of the stomach; from here it is moved by slow 
degrees toward the pylorus, from which it enters the small 
intestine. Formerly it was taught that this movement 
was brought about by a churning motion of the stomach 
throughout its entire length. Cannon has shown the error 
of this conclusion. From his observations it appears that 
the stomach is quiet at first. The waves of peristaltic con- 
striction begin at the duodenal and middle portions and 
move the food toward the pylorus. In this way the con- 
strictions that begin near the pyloric end gradually extend 
to the cardiac end. The latter part of the stomach is dis- 
tended after a full meal, but gradually diminishes in size 
during digestion. 

Moreover, there is a difference in the character of the 
gastric juice coming from the different areas of the stom- 



THE DIGESTIVE SYSTEM 91 

ach; that from the middle portion being acid, and that 
from the cardiac and pyloric being neutral or nearly so. 
These facts show that the food remains for some time in the 
fundus and meets there a neutral liquid; consequently, the 
alkalinity of the mass is retained for a time, and the saliva 
acts upon the starch for a much longer period than has 
been supposed. 

It is believed that the length of time which food remains 
in the stomach varies with its kind. The digesting mass is 
not forced into the intestine until it becomes well saturated 
with the free acid of the stomach, a result that will be 
reached later with a meat than with a vegetable diet; for 
it is plain that much more acid will be required to com- 
bine with the proteins of meat than with the smaller 
amounts in the carbohydrate foods, and so free acid is 
longer in accumulating. 

Digestion is aided by the movements of the food mass 
through the contractions of the walls of the stomach, so 
that anything which lowers the tone of the stomach or 
impairs the integrity of its lining membrane seriously 
interferes with the digestive processes. 

The nature of the food influences the rate of its passage 
through the pylorus. It has been shown by means of the 
x-rays that when the meal consisted of lean meat, suet, and 
rice, properly cooked and prepared in such a manner that 
the constituents were properly mixed together, the carbo- 
hydrates (rice) began to leave the stomach in fifteen min- 
utes, but the protein (lean meat) and fat did not begin to 
leave it under one-half hour, and were much longer in 
passing through. 

It was further found that in a normal stomach a meal of 
rice and potatoes gets out of the stomach rapidly, no trace 
being left in three hours, while a meal of protein and fat 
meat was much slower, some being present six hours after 
the meal. Indigestible substances are rejected by the 
sphincter and returned to the digestive cavity over and 
over again, but in the course of time the sphincter relaxes 
and the peristaltic contractions increase, until the force is 



92 PERSONAL HYGIENE FOR WOMEN 

sufficient to drive through the opening hard substances like 
peas, plum-stones, and coins. 

The Absorption of Food from the Stomach. — A very wide- 
spread misconception prevails in regard to the amount of 
absorption that takes place through the gastric walls. 
This is very limited indeed; some sugar, alcohol and other 
fluids, and a small proportion of nitrogenous matter are 
taken up, but that is all. The legitimate r61e of the 
stomach is a peptonizer and grinder only. Absorption of 
nutrients is the special work of the intestines, and occu- 
pies but a subordinate place in the duties of the stomach. 

Proteins undergo peptonization, but that does not 
change them sufficiently. The mere splitting into pep- 
tones, formerly thought sufficient, is now known to be quite 
inadequate. Recent researches have shown that the com- 
plex protein molecule has to be quite crushed into a hetero- 
geneous assemblage of fragments, from which those suitable 
for building up into the body protein are selected for that 
purpose, the remainder being used as fuel; that is, as a 
source of energy. In the case of the other food principles, 
fats and starches, the chemical processes are much simpler. 

Intestinal Digestion. — The chemical changes which 
food undergoes in the small and large intestines are ex- 
ceedingly complex. Digestion in the intestine is due to 
the combined action of the bile, pancreatic juice, and suc- 
cus entericus. The material which enters the duodenum 
from the stomach is known as the chyme. The acid chyme 
provokes a flow of bile and pancreatic juice. It acts upon 
the prosecretin in the duodenal mucous membrane in such a 
manner that secretin, a hormone, is formed and carried by 
the blood to the cells of the pancreas which it stimulates. 

Bile is a secretion of the cells of the liver and from the 
inner wall of the gall-bladder; after elaboration, bile is 
stored up in part at least in the gall-bladder. The secre- 
tion of bile is irregular in quantity, as is the case with the 
gastric juice, and appears to be induced by chemical ex- 
citants, of which acids, especially hydrochloric, seems to be 
especially effective. Of the nutrients, the proteins exert 



THE DIGESTIVE SYSTEM OS 

the most influence. Less secretion follows the ingestion 
of carbohydrates than of proteins. 

Formerly it was supposed that fatty foods checked the 
secretion of bile, but later experiments have proved that, 
to the contrary, they increase its secretion; and olive oil is 
a powerful cholagogue. 

Bile precipitates the proteins of the chyme, neutralizes 
the acidity of the gastic juice, dissolving the fatty acids, 
and activates the lipase or steapsin of the pancreatic juice 
and assists in the absorption of fats. When for any reason 
the discharge of bile is retarded and the organism attempts 
to eliminate it through the kidneys, the tissues become 
charged with its compounds and take on a yellowish color- 
ation. 

Pancreatic Juice. — The second action upon the food in 
the intestine is that of the bicarbonate of soda contained 
in the pancreatic and intestinal juices, which neutralizes 
its acidity; and pancreatic digestion can only take place in 
an alkaline medium. 

The pancreatic juice has the most comprehensive action 
of all of the digestive fluids; it contains a great variety of 
enzymes and acts upon all classes of nutrients. Its flow 
is intermittent, being induced by the action of the acids in 
the partially digested food from the stomach. 

The pancreatic secretion attains its maximum pressure 
about three hours after a meal, but this varies according 
to the character of the meal. The enzymes of the pan- 
creatic fluid are trypsin, amylopsin, lipase or steapsin, and 
pancreatic rennin. 

Trypsin. — Pancreatic juice alone has but little influ- 
ence on proteins, but when mixed with succus entericus its 
influence is great. Trypsin differs from pepsin by acting 
in an alkaline or neutral solution, and a free mineral acid, 
like hydrochloric, stops its operations; it acts much more 
powerfully and rapidly than pepsin. In conjunction with 
other enzymes it splits protein foods into simpler com- 
pounds, which may be regarded as the building stones of 
the original proteins. 



94 PERSONAL HYGIENE FOR WOMEN 

Amylopsin. — The digestion of starch in the intestine is 
mainly effected by means of a diastatic ferment or enzyme 
in the pancreatic juice, called "amylopsin." This enzyme 
has the power of hydrolyzing the starch mostly into 
maltose. 

Steapsin or Lipase. — The pancreatic secretion acts vigor- 
ously on fats, not only splitting them into fatty acids and 
glycerin, but, in conjunction with the bile, also effects 
their emulsification. This latter result is doubtless aided 
by the soaps which form a union of the fatty acids and al- 
kaline bases (mostly sodium) in the bile. The cleavage of 
the fats is due to the enzyme steapsin. 

The succus entericus is the secretion of the glands of 
Lieberkuhn. It contains quite a number of enzymes, in- 
cluding four which act on carbohydrates, namely, amylase, 
maltase, lactase, and invertase; the proteolytic enzyme is 
erepsin, which seems to supplement the action of trypsin. 
It has no action on native proteins except casein, but it 
breaks down proteoses and peptones into amino-acids. 

In other words, the discovery of erepsin in the succus 
entericus and its effects has led to the now almost gener- 
ally accepted view that the digestion of the proteins is 
carried further than the stage of proteoses and peptones; 
in fact, that this enzyme hydrolyzes them into amino- 
acids, in which form they are taken up by the cells of the 
intestinal mucous membrane. 

The Absorption of Food from the Intestines. — It was for- 
merly believed that the main stream of the nutrient 
passed out of the intestines through the lacteals and 
thoracic duct into the circulation. But it is now known 
that only the fats take this course, and that the dissolved 
proteins, carbohydrates, some fats and salts find their way 
into the circulation through the portal system and the liver. 

The blood contains a constant proportion of serum-albu- 
min and serum-globulin, which are constructed out of the 
amino-acids resulting from the digestion of protein foods. 
The reconstruction of proteins takes place chiefly in the 
cells. Fuchs believes that the amino-acids from the food 



THE DIGESTIVE SYSTEM 95 

are carried to all the tissues; and that the cells of the 
muscles and glands pick out from the blood the "building 
stones" necessary for the construction of their special 
proteins. 

Fat is absorbed for the most part in the form of an emul- 
sion and as a solution of soap. Only about 60 per cent, of 
the fat in the food is absorbed by the lacteals; the remain- 
ing 40 per cent, gets directly into the blood. The fat is 
carried directly by the blood-stream to the tissues all over 
the body; it is oxidized in the tissues to produce heat and 
energy; what is not immediately used for this purpose is 
stored up in the cells for future use. 

Carbohydrates. — Practically all of the carbohydrates 
digested are absorbed in the form of sugar. The absorp- 
tion takes place more rapidly in the upper than in the 
lower bowel. A portion of the ingested carbohydrates is 
destroyed in the alimentary canal by bacteria, whose en- 
zymes transform them into various acids and gases. 

The Absorption of Sugar. — The sugars pass into the blood 
through the portal circulation, and not through the lymph- 
atic vessels. The question is, Where does sugar go after it 
gets into the blood? The proportion of sugar in the general 
circulation is not greater after a meal than before it. It is 
necessary that there should be some means of storing it, for 
it cannot all be immediately used for the production of 
energy. Is it stored as glycogen? Bunge believes that a 
considerable amount of carbohydrate is stored as fat, since 
the total amount of glycogen in the liver never exceeds 
150 grams, and there is a similar store in the whole mass 
of muscles. It is evident, therefore, that only a small 
proportion of carbohydrates is laid down as glycogen, and 
we must assume that the greater part of it is converted 
into fat. That fat accumulates in the body on a purely 
carbohydrate diet is proved beyond a doubt, and the for- 
mation of fat from sugar is considered proved by exper- 
imental evidence. 

Sugar is an important source of energy for the muscles, 
and provision is made for a sufficiency of it always to be in 



96 PERSONAL HYGIENE FOR WOMEN 

the blood circulating through them, and the storehouse 
from which it is derived is the liver. When the liver and 
muscles contain enough glycogen to keep the blood supplied 
with it, the excess of sugar is converted into fat, and is re- 
converted into sugar when there is a demand for it. 

Mechanics of Digestion in the Intestines. — The intestinal 
movements, like those of the stomach, have recently been 
studied by means of the z-rays. There are three kinds: 
A pendulum-like motion, consisting of a gentle, sway- 
ing, rhythmic movement occurring in all parts of the 
intestines. These movements do not affect the whole of 
the gut at one time, but occur in successive segments of it, 
and are more obvious in those parts which are distended 
with food, at a period of three or four hours after a meal. 
They are most energetic in the upper and least so in the 
lower part of the gut, and proceed from above downward 
with the course of the food. 

The movement consists in lengthening and narrowing, 
followed by shortening and widening, of the canal; the con- 
traction involves both the longitudinal and circular mus- 
cular coats, and in the course of its progress divides the 
bowel into many segments. This movement breaks up 
the food, sways it backward and forward, diffuses the 
digestive fluids through it, and drives chyle into the 
lacteals. 

The second kind of movement consists of peristalsis, or 
wave-like propulsive movements; also localized dilatation, 
followed by contraction of the canal, progressing from 
above downward at the rate of 1 or 2 inches per second, 
and is from three to four hours traveling the entire length 
of the intestines. 

Under pathologic conditions a third movement is ob- 
served, consisting of a swift venicular movement, starting 
at the pylorus and traveling the entire length of the gut 
in about one minute. It is produced by toxins, gases, and 
other irritants. 

Digestion is practically completed in the small intestine. 

The colon consists of a proximal portion, consisting of the 



THE DIGESTIVE SYSTEM 97 

cecum, ascending colon, and one-half of the transverse 
colon ; a mesial part, formed by the other half of the trans- 
verse colon and part of the descending colon and a distal 
portion, formed by the remainder of the descending colon 
and of the rectum. The contents of the proximal portion 
are fluid; food accumulates in this portion; it is gradually 
concentrated by the absorption of water. It has been 
shown by the x-rays that a meal reaches the cecum in four 
or five hours; the hepatic flexure in six or seven hours; the 
splenic flexure in nine hours; and the rectum in about 
eighteen hours. 

The feces consist of the residue of the food, digestive 
secretions, etc. The contents of the alimentary canal be- 
come altered in character as they descend its course. The 
mass attains a greater density as it descends, more and 
more nutrient being absorbed from it, and even in the 
colon it becomes more solid; its color is brownish and its 
odor characteristic. The amount of feces from an aver- 
age mixed diet represents from one-seventh to one-eighth 
of the food consumed. 

Defecation. — The waste matter which collects in the 
lower bowel must be evacuated every day. Allowed to 
remain longer than this, the digestive system is clogged by 
the non-removal of worn-out material, and the blood is 
constantly absorbing matter which is poisonous to the 
body. Decomposition goes on without being suspected 
by the sufferer. 

Intestinal bacteria or organized ferments are present 
throughout the entire intestinal canal and play a part in 
the food changes. They are most abundant in the lower 
part of the small intestine and the upper part of the large. 
They act upon the proteins, causing putrefaction, dissolve 
cellulose, and cause a decomposition of the carbohydrates. 
The products of these fermentations include indol and 
skatol, which have the characteristic fecal odor; volatile 
fatty acids and gases, some of which are carbon dioxid, 
hydrogen, marsh-gas, and hydrogen sulphid. 

Fermentations of this character up to a certain extent 
7 



98 PERSONAL HYGIENE FOR WOMEN 

are normal and may be beneficial, but they may proceed 
so far as to be deleterious to health. Anything which 
retards digestion, such as imperfect mastication, excessive 
eating, abnormal amounts of meat in the diet, and failure 
of the organs secreting the digestive fluids to supply these 
secretions in sufficient quantity, gives these bacteria a 
better opportunity to act on the food residues and so in- 
creases their bad effects. 

Some foods, especially vegetables of the leguminous 
class, appear to be provocative of excessive intestinal fer- 
mentation. Flatulence and even toxic poisoning may be 
the result of great bacterial activity in the digestive tract. 
It is hardly possible to check this by administering septics, 
but purging is of value by removing the fermentative 
material. Particular foods, especially soured milk and 
kephir, have been shown to have a preventive action on 
putrefaction. 

Influence of Food on Secretion. — The more recent inves- 
tigations reveal the fact that the kind of food has an influ- 
ence not only on the abundance, but also on the kind of 
digestive secretions; this is most important because an 
abundant supply of digestive juices is necessary for good 
digestion. Broths, meat extracts, and milk stimulate the 
secretion of the gastric juice, which makes rational the 
taking of soup or bouillon as the first course at dinner, or 
the eating of toast or zwieback by persons with weak di- 
gestions. Fats, on the other hand, tend to inhibit gastric 
secretion, so that an excessive proportion of fat in the meat 
might hinder digestion in the stomach. 

Food may exert an indirect influence on the pancreatic 
secretion. The acid in the chyme stimulates the flow of 
pancreatic juice. One is almost inclined to speak of the 
physiologic education of the digestive glands, and to con- 
ceive them as being trained for fat, protein, or carbohy- 
drate digestion. 

Metabolism. — Life consists, so far as material phenom- 
ena are concerned, in the transformation of matter into 
energy. To these transformations the term metabolism is 



THE DIGESTIVE SYSTEM 99 

applied. In the metabolism of matter the changes are 
chemical; in energy the changes are physical. It is com- 
monly assumed that the laws of conservation of matter and 
energy are conformed to or obeyed in animal bodies. 

The body converts potential into kinetic energy by 
metabolism in the body. The potential energy of food is 
transformed into the actual energy of heat and mechanical 
labor. In this respect the only difference beteen man and 
other vertebrates is the nervous and intellectual processes, 
which are not yet understood. 

Metabolism is anabolic and katabolic. Anabolism is 
constructive; it includes growth and the act of the tissues 
in selecting, appropriating, and making substances ab- 
sorbed from the alimentary canal a part of themselves. 
The body is never stable; while growth and nutrition pro- 
gress, destruction or demolition takes place, and this is 
called katabolism. To ascertain the exact amount of 
matter and energy used daily by the body a balance sheet 
of the exchange of material is necessary. The income 
consists of (a) matter — food, drink, and the oxygen of the 
air; (6) energy, the potential energy of the food and drink. 
The outgo consists of (a) matter in the feces, urine, perspira- 
tion, and breath; (6) energy — the potential energy of feces, 
urine, products of respiration, and perspiration. A com- 
plete account would show the amount of C, N, H, 0, P, S, 
CI, Na, Ca, K, Mg, and Fe in the income and outgo, it 
would also show the compounds in the excreta, including 
proteins, carbohydrates, water, and carbonic acid. 

Experiments show that the body requires a given quan- 
tity of given energy producing substances for sustenance, 
and something more to meet the demands for muscular 
work. 

The metabolism of nitrogen is usually measured by the 
amount of urea in the urine, taking into account the 
small proportion of uric acid and other nitrogenous bodies. 
In fasting the organism lives on its own flesh and fat. 

The Effects of a Nitrogenous Diet on Metabolism. — The 
most striking effect of a purely nitrogenous diet is a large 



100 PERSONAL HYGIENE FOR WOMEN 

increase in the nitrogenous metabolism, but it also in- 
creases the metabolism of the non-nitrogenous elements of 
the body. With an ordinary mixed diet the normal ex- 
cretion of urea varies from 33 to 37 grams a day, while 
with a meat diet the urea may rise to 50 or even 80 grams 
daily. 

Carbohydrates as a Protein Protector. — It has long been 
observed that when there was a deficiency of protein in the 
food the metabolism of nitrogen will be spared and the 
tissues protected if the food contains plenty of carbohy- 
drates and fat. The subject was fully investigated by 
Lusk. When the diet contains an abundance of protein, 
carbohydrates, and fat the organism gains a little nitrogen; 
when the diet contains the same amount of protein but 
no carbohydrates, the body loses considerable nitrogen. 
Again, when the food was the ordinary mixed kind, and 
contained a sufficiency of energy, but was of a low protein 
character, the excretion of nitrogen was normal. These 
results led to the conclusion that the carbohydrates were 
a protein protector. 

Fat as a Protector of Proteins. — The metabolism of nitrog- 
enous tissue and elimination of nitrogen is not prevented 
by the consumption of fat, but the consumption of fat 
reduces the metabolism of protein so much that one-quarter 
or one-third as much meat will suffice to maintain the 
nitrogen equilibrium as would have to be consumed if only 
lean meat was used. 

The nutritive value of meat extracts is comparatively 
small; their chief value is in promoting digestion and 
metabolism of other foods. 

Water and Metabolism. — The body consists of 530 parts 
of water per 1000. It is of greatest importance as a com- 
ponent of the tissues to assist in the exchange of nutritive 
substances, the discharge of the products of metabolism, 
the regulation of temperature, and other vital functions. 
If the supply of water is stopped the body will die, and it 
may die sooner from the deprivation of water than from 
starvation. 



THE DIGESTIVE SYSTEM 101 

A reduction in the amount of water consumed acceler- 
ates the decomposition of protein and fat to replace the 
water essential for the bodily functions. As the result 
of experiments it has been found that the average income 
of water is 4 pints, and the excretion is 4 J pints; so that 
at the lowest estimate \ pint of water is formed in the tis- 
sues by the oxidation of hydrogen in the food and tissues ; 
and during ordinary work it was found that 17 ounces of 
water was excreted daily in excess of that consumed in 
food and drink. 

The intense suffering entailed by prolonged thirst is to 
be accounted for by the absolute necessity for preserving 
the normal aqueous dilution throughout the body. 

Water is also essential for removing the effete materials 
arising from metabolism, cell growth, and other disintegra- 
tion. 

Chlorids. — About 15 to 18 grams of sodium chlorid 
(common salt) are excreted daily in the urine, and smaller 
quantities in the feces and perspiration. It is, therefore, 
a most important food. The tissues retain common salt 
most tenaciously, and when there is none in the food it 
gradually disappears from the urine. It facilitates the 
absorption of the protein foods and increases tissue metabo- 
lism. And, further, an insufficiency of common salt is 
followed by a diminution of hydrochloric acid from the 
gastric juice, and consequently a failure of nutrition. 
There can be no doubt that the hydrochloric acid of the 
gastric juice originates from the chlorids of the blood. 

On the other hand, a very large number of people con- 
sume more salt than they require. Salt is not only a food, 
it is a condiment, and as such it is liable to abuse. It has 
been estimated that from 2 to 4 grams of salt a day is 
sufficient, whereas most people take from 20 to 30 grams 
daily in one way or another. The kidneys have to excrete 
the excess of salt, which they seem to do in health without 
any difficulty; but in nephritis the kidneys do not excrete 
it so readily, and this may lead to a retention of salt in the 
body. 



102 PERSONAL HYGIENE FOR WOMEN 

Iron is essential to the human body. It is taken into 
the body in the form of food, and is excreted from the 
body in the bile and feces. It has been estimated that 
typical food contains 10 mgm. of iron daily. The hemo- 
globin of the blood contains 0.04 per cent, of iron. 

Constipation. — It must be remembered that the intes- 
tine is a permanent source of poisons, which, under certain 
conditions, cause grave alterations in the principal organs, 
notably in the liver, kidneys, and skin, and serious func- 
tional disturbances of the nervous system. 

Normally, the organism manages to protect itself against 
the microorganisms which are found in the intestines; 
given, however, certain conditions, the toxic products 
can be generated in excess of the powers of the organism 
to dispose of them, such as errors of diet, quantitative 
or qualitative, atony of the muscular walls of the intestine, 
and, above all, constipation. The higher up in the in- 
testine the stasis occurs, the more serious is the result. 
Constipation is considered by many surgeons as the most 
important factor in the production of appendicitis. 

There is frequently a condition present which is known 
as semiconstipation, and which is most deceptive to the 
patient. There may be a bowel movement every day, 
but the bowel is never emptied; only the lower portion of 
the hardened fecal matter is broken off. This is repeat- 
edly found to be the case in examining women for some 
form of pelvic trouble, and in a woman who says that she 
has a daily evacuation of the bowels, and has had one that 
very morning, the sigmoid flexure will be found to be 
packed with hardened feces. 

Besides the clogging up of the digestive system by the 
non-removal of the waste-products of digestion, the 
formation of hemorrhoids, which is caused by the mechan- 
ical pressure on the veins, and so interferes with their 
emptying out in the normal way, and the general auto- 
intoxication of the entire system, there are also caused in 
women serious displacements of the pelvic organs to- 
gether with their congestion and inflammation. 



THE DIGESTIVE SYSTEM 103 

The general symptoms of autointoxication are: head- 
ache, vertigo, palpitation of the heart, a feeble and irreg- 
ular pulse, irritability of temper, melancholia, numbness 
and tingling in the hands and feet, and the emaciation and 
loss of weight are sometimes so marked as to lead to the 
suspicion of malignant disease. 

Treatment of Constipation. — This should always be 
preventive, and the diet is a most important factor. The 
food should be of a coarse quality, that is, such as directly 
stimulates the walls of the intestine to contraction by their 
constitutents, or by the large amount of the indigestible 
bulk. Corn and Graham bread should be substituted for 
white bread. Toast is always constipating. Plenty of 
fresh fruit and vegetables should be eaten. For those who 
can digest them, raw apples, eaten just before retiring, are 
a great aid. The drinking of a sufficient quantity of water 
daily is also essential, and this quantity must be 3 pints. 
A glassful of cold water, taken the first thing in the morn- 
ing on rising, is often very effective. If this is insufficient, 
the phosphate of soda, one teaspoonful to one tablespoon- 
ful, may be added. 

Habit. — Nowhere is the effect of habit more conspicuous 
than in the matter of a daily evacuation of the bowels. 
There should be a fixed time every day for this, and the 
very best time is in the morning, directly after breakfast. 
Such a habit, once established, will enforce itself upon the 
attention and make regularity a necessity. It not infre- 
quently happens that constipation is the result of irregu- 
larity in going to the toilet. The school-girl or woman 
gets up a little late, and, although she may feel the inclina- 
tion to empty the bowels, she is able to defer it. 

If the movement is sufficiently large, one stool daily is 
sufficient, but where the stool is slight in quantity, there 
may be two or three during the day, entirely consistent 
with health, and in a run down state of the system there 
are apt to be several small movements rather than one full 
stool. So long as the stools are not watery, the individual 
may rest assured that there is no looseness of the bowels. 



104 PERSONAL HYGIENE FOR WOMEN 

Constipation should never be allowed to become chronic. 
It is, as has already been shown, the progenitor of myriads 
of the most serious diseases; and, after the bad habits 
of years have been established, it is one of the most 
obstinate of diseases to cure. In every case a good 
physician should be consulted at once, and the treatment 
should be persevered in until the cure is complete. It is a 
well-known fact that all medicines for this trouble lose 
their effect, the dose has to be increased, and a frequent 
change made from one laxative to another. When every- 
thing else fails, electricity may be resorted to. It is one 
of our most valuable remedies, since it brings about a cure 
through the toning up of the muscular walls of the in- 
testine. 

The constant use of hot clysters to empty the rectum 
is one of the most pernicious habits; in this manner the 
bowel becomes overdistended and loses its tone, and the 
fecal mass is not sufficiently large to cause the distention 
of the rectum, which is the normal stimulus leading to the 
desire to defecate. 

The Amount of Food Required. — Food is required for 
growth and for repair ; that is, to build up the organism and 
make good the loses sustained by physiologic processes, to 
maintain the heat of the organism, and to supply it with 
mechanical energy. 

It has become an established custom to compare the 
human body to a machine. Both derive their power from 
fuel; in both instances the potential energy of the fuel is 
transformed into kinetic energy or mechanical power 
which works the machine; in both cases the energy which 
is not used in work escapes in the form of heat. 

The human body uses the mechanical power chiefly in 
muscular work; the heat is used in warming the body and 
causing the evaporation of moisture from its surface. The 
animal organism is much superior to the mechanical engine. 
It is more economic in the use of fuel; it has a nervous 
organization rendering it sensible to impressions and cap- 
able of directing its energies. The human machine is 



THE DIGESTIVE SYSTEM 105 

capable of adapting itself to many circumstances and 
changes in the demands upon it. 

But to enable the body to continue to perform these func- 
tions indefinitely it must be properly fed, and a proper feed- 
ing of the body requires a knowledge of its composition and 
the exchanges which are constantly going on. This knowl- 
edge is to be derived from a study of its metabolism, the 
analysis of foods, and a determination of their heat values. 

The Classification of Foods. — Foods are divided into 
proteins, carbohydrates, fats, mineral salts, and water. 
The body is composed of materials belonging to the same 
groups. Proteins form the principal part of muscles, bones, 
and many other tissues of animal bodies ; they also consti- 
tute some of the most important vegetable structures. 

Proteins are probably the most complex compounds in 
nature; all contain carbon, hydrogen, oxygen, and nitrogen, 
generally sulphur, and sometimes phosphorus also. They 
are, with rare exceptions, colloids, that is, glue-like, non- 
crystalline bodies, which even in solution cannot pass 
through animal membranes. 

The building stones of the body are the amino-acids. 
All proteins contain them, but the kinds and proportions 
are not always the same. It has been shown by biologic 
experiments that life and growth cannot be maintained 
when certain amino-acids are deficient. 

Proteins are of use to the human body as tissue formers, 
and, secondly, as producers of energy, but they also have a 
food value as flavoring agents, rendering the food appetiz- 
ing, and so are to a certain extent stimulants. The palat- 
ability of meats and soups are due to their presence. The 
amino-acids have decided heat value. 

The necessity for proteins in the diet has been abun- 
dantly demonstrated. Many investigations have shown 
that when the food contains no protein the waste of nitro- 
gen continues, no matter how abundant the supply of car- 
bohydrates and fats. In other words, a continuous pro- 
tein cleavage is demanded by the animal organism, and 
no other nutriments can serve as a substitute for protein to 



106 PERSONAL HYGIENE FOR WOMEN 

meet this demand. If the food contains no protein, the 
body tissues will be depleted. It cannot be said that car- 
bohydrates or fats are an essential part of the diet in the 
sense that protein is, because it is possible to substitute one 
for the other to produce energy, or to substitute proteins for 
both. 

In spite of these facts, it is safe to assert that the wel- 
fare of the human organism is best promoted by a mixed 
diet, including all three classes of food. The larger part of 
man's food is used for the production of energy, and it is 
physiologically economic that this energy be supplied by 
the non-nitrogenous nutrients, particularly the carbohy- 
drates, and to allocate to protein, so far as practicable, its 
special role of building material. 

Nitrogenous Waste Products. — The end-product of 
proteins is urea, which is formed from protein decompo- 
sition products in relatively large amounts in the liver 
cells, and, being readily soluble and diffusible, is easily 
eliminated by the kidneys. Besides urea there are other 
smaller quantities of nitrogen compounds, the one most 
deserving of notice being uric acid. 

When the proteins are broken down to supply energy, 
there is always a definite proportion of urea and uric acid 
residue that must be eliminated through the kidneys. An 
excessive protein diet would burden these organs beyond 
their accustomed habit, and flooding the system with 
these nitrogenous wastes increases the tendency to rheu- 
matism and gout. 

Uric acid is of general interest, and when present in the 
system in abnormally large amounts, as in gouty persons, 
has a pathologic significance. It is more complex in its 
composition, and, what is of particular importance, is that 
it does not readily dissolve. It forms very insoluble salts 
which have unpleasant tendencies to settle in the joints, 
causing great pain. Did its metabolism proceed properly, 
it should be resolved into urea and carbon dioxid. The 
quantity of uric acid that appears in the urine is the residue 
that has escaped this oxidation. 



THE DIGESTIVE SYSTEM 107 

Uric acid is built up from purin bodies in the food, so 
that it would be well for those with a gouty diathesis to 
abstain, at least when an attack of gout threatens, from all 
aliment in which purin is at all abundant. The most 
valuable of the purin-free foods are eggs and milk, and to 
these the uric-acid sufferer has to turn in times of trouble. 

Carbohydrates Physiologically Economic. — This group 
of compounds comprises starches, sugars, and gums; the 
elements of which they are composed — namely, carbon, hy- 
drogen, and oxygen — are so balanced that if all of the car- 
bon were removed the residual hydrogen and oxygen would 
be in the proportions to form water. 

Carbohydrates are usually characterized as the fuel por- 
tions of the food, or, in other words, that part which is 
burned to produce the various forms of energy. They are 
also essential for the well-being of the organism; reduction 
of the intake below the essential point frequently leads to 
acetonuria. 

When the metabolism is perfect, any carbohydrates con- 
sumed in excess of the ordinary requirements are converted 
into glycogen and fat and stored for providing fuel at a 
future date. When stored as fats they are completely oxi- 
dized in the simplest compounds, carbon dioxid and water, 
and are eliminated through the lungs and skin, possibly 
part of the water so formed acting as a solvent for the 
urinary compounds. Investigations seem to prove that 
the body has a preference for the carbohydrates over fats 
or other nutrients as a source of energy. There is every 
justification for the abundance of starches in man's diet. 

Fat is essential in the food of mankind; it is absorbed 
ready formed from the food, or manufactured in the body 
from the proteins and carbohydrates. Neutral fats and 
fatty acids are valuable foods; their primary function is to 
supply the body with fuel for heat and energy. 

The mineral substances form 5 or 6 per cent, by weight of 
the human body, and are constantly leaving it by different 
channels; they are indispensable elements of food. They 
give solidity and stability to the organism, constituting a 



108 PERSONAL HYGIENE FOR WOMEN 

considerable proportion of the bones. They keep various 
proteins in solution and confer upon them the property of 
electric conductivity. They are necessary for all of the 
secretions and assist in the general metabolism. The car- 
bonates of soda, potash, iron, and other minerals render the 
blood and secretions alkaline. The removal of carbon di- 
oxid is performed mainly by the alkaline carbonates, which 
take it from the blood and surrender it to the lungs. We 
have already considered the need of sodium chlorid. The 
total daily requirements of salts is estimated at about 360 
grains. 

Vitamins a New Factor in Nutrition. — But recent in- 
vestigation has proved that something more is essential 
for the maintenance of growth and well-being than pro- 
tein, carbohydrates, fats, and salts; that food contains a 
minute portion of accessory bodies, and that when they 
are deficient or absent from the diet the immature body 
does not grow, the mature body does not maintain its 
condition, and there are manifestations of more or less 
serious disease. These accessory bodies have been called 
" vitamins," and they are essential to maintain the normal 
metabolism of the body. 

It is recognized that although vitamins are undoubtedly 
widely distributed in food products, they occur for the 
most part in very minute amounts, and the various foods 
differ in the proportion which they contain. If the diet is 
made up of substances which are poor in vitamins, or ren- 
dered so by their mode of preparation, abnormal metabolic 
processes have been found to follow. 

The study by many scientists during the past few years 
of the enzymes and their striking specificity; of the salts; 
of the insufficiency of many proteins, and of the vitamins 
is epoch making, and has caused a corresponding advance in 
dietetics. These discoveries are so important as to raise 
the question whether nutritive failure or success does not 
depend as much on the accessory bodies — the vitamins, 
the enzymes, and lipoids — as on the primary element of 
the diet. 



THE DIGESTIVE SYSTEM 109 

In addition to these food principles, there exists in our 
food a number of compounds which, while not indispen- 
sable, act beneficially as flavorings, stimulants to diges- 
tion, etc.; these are termed food adjuncts, and comprise 
such bases as caffein, essential oils, organic acids, etc. 

Standard Dietaries: The Maintenance Diet. — There is 
great need of standardization and of knowledge regarding 
the maintenance diet, first among physicians and then 
among the people in general, or scientific dietaries based 
on the nutritive value of foods. These are given in terms 
of proteins, carbohydrates, and fats, together with the 
aggregate energy of the nutritive value in each. This is 
the corner-stone of dietetics. 

Dietetics is the science of feeding. It has to do with the 
necessities of the body and the ability of the food to meet 
these necessities in the various circumstances and condi- 
tions of life. The ultimate scientific knowledge concerning 
human nutrition should be to promote the healthful and 
economic use of food. 

The problems to be dealt with are quite complex. 
These are: (1) changes in the economic conditions of the 
population; (2) changes in food production and food sup- 
ply; (3) changes in the methods of preparing food. 

In regard to the influence of the economic conditions 
of the people on the composition of their diet, it might be 
expected that a considerable decrease in the earning capac- 
ity of the poorer people, or an increase in the cost of foods, 
would be followed by a change in their diet. Everyday 
experience teaches that under such conditions the more 
expensive foods — meat, eggs, and milk — are reduced in the 
diet. These same foods are also rich in vitamins, so that a 
reduction here would, therefore, reduce the vitamin con- 
tent of the dietary unless other dietary complements 
rich in vitamins, such as legumes, were introduced. 

The value of any food as a source of heat and energy is 
measured by a bomb-calorimeter. The heat given off 
during the combustion is a measure of the latent or poten- 
tial energy of the food. The kinetic energy of the food is 



110 PERSONAL HYGIENE FOR WOMEN 

the amount of heat developed by the proportion which is 
digested. The unit commonly used is the calorie, or the 
amount of heat which would be required to raise the tem- 
perature of 1 kilogram of water 1° C, which is about 
equal to that required to raise the temperature of 1 pound 
of water 4° F. • 

Heat Value and Digestibility of Foods. — One of the chief 
functions of food is to supply the body with heat and en- 
ergy; the food must be capable of digestion and absorption. 
Herein lies the exact value of any food to the consumer. 
In science the figures that are given for the digestibility 
of the various foods refer to the completeness or extent to 
which the food is dissolved and transferred to the circula- 
tion, and an indigestible one is that of which a considerable 
portion passes out of the system into the feces without be- 
ing disintegrated and absorbed. 

Animal food is more completely digested than vegetable 
food, as shown by the difference of nitrogen in the feces. 
In meats 97 per cent, of the protein and 98 per cent, of the 
fat are absorbed. Lean meat is more rapidly digested than 
fat, and the flesh of young animals than that of older ones. 

The breast of chicken, fresh beef, and mutton are among 
the most digestible of the solid foods. Raw and rare meats 
are more easily digested than well-done meats; in other 
words, cooking lessens the digestibility of meats. Steak 
should be broiled and never fried; all fried foods are difficult 
to digest. Veal and pork are both difficult to digest. 

Eggs are almost as nutritious as meat; their digestibility 
is unsurpassed and only equalled by a few foods, such as 
milk and oysters. They are most easily digested when 
soft boiled or poached. Dry toast finely broken up and 
mixed with a soft-boiled egg aids in its digestion. Soft- 
boiled eggs are more easily digested than raw eggs, but 
the latter are less irritating to the stomach, probably be- 
cause they are digested in the intestines. It has been 
found that two poached or soft-boiled eggs leave the stom- 
ach in from two to three hours; that is, in the same time 
as milk, oysters, white bread, and light fish. 



THE DIGESTIVE SYSTEM 111 

Milk. — Although one of the most completely digested 
of foods in a mixed diet, milk is not quite so completely 
digested as meat and eggs. When milk is the sole food 
(milk diet) the proportion digested depends partly on the 
amount consumed. With the consumption of 3 J pints 
of milk daily the loss of milk solids varies from 10 to 11.16 
per cent. Young children digest milk more completely 
than adults. 

The addition of aerated waters or crackers broken up in 
the milk prevent the formation of tough clots, and hence 
render it more digestible. Hot (not boiled) milk is more 
digestible than cold. Boiling increases the toughness of 
the curd, but it destroys the bacteria. Buttermilk and 
koumiss are more easily digested than cows' milk. 

Wheat flour enters largely into the diet of every family. 
In producing it the outer coating of the wheat kernel is 
removed, thus throwing into the milling offals that part of 
the kernel which is most heavily charged with mineral 
ingredients and vitamins. The proportion of digestible 
proteins in white flour is not less than in whole wheat flour, 
as is so often claimed, but because the latter is richer in 
mineral ingredients its use is recommended. 

Bread is readily digestible; white bread digests more 
rapidly than brown or black; and crackers more rapidly 
than either. 

Rice is another cereal of great economic importance. 
As a food for invalids it possesses a high value on account 
of its digestibility, especially in intestinal diseases. Or- 
dinarily polished rice contains only 0.5 per cent, of cellu- 
lose, and almost all of the substance of the grain is 
absorbed. 

There is a perfect analogy between the well-known re- 
lation of the polishing of rice to its nutritive value, and the 
milling of wheat and corn to the nutritive value of wheat, 
flour, and cornmeal; that is, it loses the mineral ingredients 
and vitamins. 

Potatoes. — In European countries potatoes rank next to 
bread; this arises from the ease of their digestion. From 



112 PERSONAL HYGIENE FOR WOMEN 

92 to 95 per cent, of the starch is absorbed, but there is a 
loss of 23 per cent, of the protein. 

The manner of preparation of vegetable foods determines 
the proportion of loss. When potatoes are baked or boiled 
in the skins the loss is negligible. The greatest amount of 
loss occurs when the skins are removed, the potatoes then 
allowed to soak in cold water, and placed in cold water to 
boil. The potatoes should be pared just before cooking, 
and the water should be boiling hard before they are put in. 
Mealy potatoes digest more rapidly than waxy ones, and 
mashed quicker than unmashed. 

Oatmeal, barley meal, and other cereals which are not 
ground very fine do not digest so easily as wheat flour, but 
much depends on the mode of cooking. When oatmeal- 
gruel is consumed with a sufficient amount of milk it forms 
a complete diet. 

Nuts are valuable as a source of protein and fat, but they 
are rather difficult of digestion. 

Fats. — As a rule, children do not thrive whose diet is 
deficient in fats, and even adults are prone to tuberculosis 
and nervous diseases when fat in the body is deficient. 

Cheese is one of the most indigestible of foods. All 
fried foods are highly indigestible because the fat envelope 
of the foods has to be melted off before the gastric juice 
can act on the food substance itself. Pastry is also very 
indigestible. Of the vegetables, beans, while highly nu- 
tritious, are exceedingly difficult of digestion; also boiled 
cabbage, cauliflower, hot breads, iced drinks, ice-cream, 
and water-ices. 

The Relation of Diet to Various Conditions of Life. — 
The chief factors influencing bodily needs are age, height, 
weight, occupation, idisoyncrasies, and atmospheric con- 
ditions. 

All activity of the human body, whether in the main- 
tenance of its functions or in the performance of labor, is 
work. These two forms of work may be classified as 
physiologic and mechanical. Nothing in nutrition is more 
important than the relation of food to work. 



THE DIGESTIVE SYSTEM 113 

Children are practically in constant motion during their 
waking Hours, and their demand for food energy is from 
two to three times as much per unit of weight as that for 
adults. 

Sex. — Men and women of the same age and weight, doing 
the same kind and amount of work, require the same 
amount of food. The fact that men usually require more 
food than women is because, as a rule, they weigh more, are 
more active physically, and perform more external work. 

Temperament. — Persons of a nervous type, being more 
active, use more energy than the phlegmatic, and, there- 
fore, require more food. 

Brain Workers. — A man whose work is sedentary and 
chiefly mental does not need so much food as a man doing 
muscular work. The amount of carbohydrates required 
is less, and the amount of fat rather more than for the man 
doing light muscular work. 

Ranke's diet for the brain worker is: Protein, 100 grams; 
fats, 100 grams; carbohydrates, 240 grams; giving an energy 
value of 2310 calories. 

The diet should not be bulky, but light and easily di- 
gestible. Excess of food and heavy foods are especially 
bad for brain workers because they produce heaviness, 
dulness, and drowsiness. Spiced and rich foods upset the 
alimentary functions, whereby the circulation is flooded 
with the products of imperfect metabolism to the detri- 
ment of the brain. 

Trained workmen will do a given amount of labor on less 
food than untrained, because when persons take up 
mechanical operations with which they are unfamiliar, or 
undertake work which exercises a new set of muscles, a 
unit of work accomplished costs more in food energy than 
when the muscles have been trained to do a particular 
thing. 

Very strenuous exercise, like athletic contests and unnat- 
urally slow movements, are both wasteful of food energy. 

Again, a continuance of the same labor for hours, and a 
state of fatigue, whether it comes after a longer or shorter 

8 



114 PERSONAL HYGIENE FOR WOMEN 

time, causes an increase in the energy expenditure per unit 
of work performed. 

Economy in the use of energy that food supplies to the 
body is most fully secured when the movements of the 
body are at the natural rate; when periods of intense effort 
do not occur, and when the labor is not too long continued 
and is not carried to the point of fatigue. 

Standard for Daily Dietaries (American) — Atwater. 

Fuel 
Protein, value. Nutritive 
Grams. Calories. ratio. 

Woman with light muscular exercise 90 2400 5.5 

Woman with moderate muscular work .... \ -, nft o7nn k a 

Man without muscular work / iUU Z ' UU &b 

Man with light muscular work 112 3000 5.5 

Man with moderate muscular work 125 3500 5.8 

Man with hard muscular work 150 4500 6.3 

The Relation of Food Economics to Social Welfare. — 
A virile nation is one whose citizens are of a good physical 
type, which means that they are well nourished. A well- 
fed people, other conditions being favorable, is a strong 
people. Food is the physical basis not only of the indi- 
vidual activity, but also of social energy. Any causes, 
therefore, which limit the food supply or increase the 
burden of securing adequate nourishment strike a blow 
at the nation's vital power. 

We must constantly keep in mind that the energy output 
is practically the energy requirement, under given condi- 
tions, of course; and the expenditure caused by the mus- 
cular activity of a particular individual cannot be reduced 
without affecting the work done or causing the loss of body 
substance. 

Investigation has shown that there is a necessary daily 
protein minimum use. When insufficient protein is taken 
in the food, the necessary balance will be supplied by draw- 
ing on the tissues of the body. The food standards which 
are based on the observation of practice call for not less 
than 100 grams of protein daily for professional men and 
175 grams for men at severe labor. 



THE DIGESTIVE SYSTEM 115 

It is held to be significant that communities holding 
leading positions in the world consume a liberal amount of 
protein, or, conversely, that communities with an inferior 
physical and mental status use a low proportion of proteins 
in the diet. Again, if we argue from the analogies in feed- 
ing farm animals, generous protein feeding is desirable for 
the growth and maintenance of vigorous organisms and a 
satisfactory rate of production. 

On the other hand, the well-known experience of the 
ages has shown that the poor who live on a low protein diet 
are the most liable to disease. It cannot be gainsaid that 
the meat eater has greater stamina and energy than the 
one whose diet is poor in protein. 

The conclusion is, that while a minimum of protein is 
essential to the organism, a greater proportion is advan- 
tageous by acting as a stimulant to the metabolism and as a 
ready source of energy; that people are better for the con- 
sumption of proteins in quantities greater than in Chit- 
tenden's standard, and possess greater resistance to dis- 
ease, probably because the body is stimulated to manu- 
facture antibodies. 

Practical Facts for Guidance. — The housewife who keeps 
the following facts in mind may combine foods in an ap- 
proximate way that will fully meet the demands of the 
human organism. 

The proper ratio is 1 part of protein to 5 parts of non- 
protein; and the fat should equal one-half of the weight 
of the protein. This gives the following normal dietary: 

Energy 

Weight. supplied. 

Grams. Ounces. Calories. 

Protein 100 3£ 410 

Carbohydrates 400 14| 1640 

Fats 50 If _465 

2515 

Proportion of Proteins in Foods. — Foods Rich in Pro- 
teins. — Lean meat, dried peas, beans, and lentils, 18 to 25 



116 PERSONAL HYGIENE FOR WOMEN 

per cent. ; fat meat, 12 to 18 per cent. ; eggs, 12 per cent. ; 
oatmeal, 10 to 15 per cent. ; cheese, 25 to 35 per cent. 

Foods with Moderate Amounts of Proteins. — Milk aver- 
ages 3| per cent. ; fresh peas, beans, and lentils, 3 to 8 per 
cent. ; white bread, 6 to 7 per cent. ; fine wheat flour and 
barley, 8 to 10 or 12 per cent. 

Food with Usually Less than S Per Cent, of Proteins. — 
Green vegetables, potatoes, and roots, such as carrots, 
turnips, and onions, etc. 

Legumes and certain nuts supply relatively more protein 
than other vegetable foods, so that when the cost of meat, 
fowl, fish, eggs, or milk is prohibitive, the freer use of beans, 
peas, lentils, and nuts is strongly recommended. 

The unmodified foods, such as grain, vegetables, fruit, 
meat, eggs, and milk, may be depended upon to amply 
supply all the necessary elements to sustain growth, func- 
tions, and waste of the human body. On the other hand, 
foods which it is proper to designate as "artificial" are not 
only not essential to an adequate diet, but when they are 
used freely may render a diet very one-sided or deficient. 

Foods may be so selected as to furnish an abundant 
supply of mineral ingredients. For instance, the dry sub- 
stance of certain vegetables like asparagus, lettuce, spin- 
ach, and such animal foods as eggs, and beef extracts are 
relatively rich in iron compounds, and the dried substance 
of leguminous seeds, carrots and other vegetables, milk, 
and cheese are relatively rich in calcium compounds. 

Variety of foods is necessary, for monotony of even the 
best kinds leads to satiety, loss of appetite, loathing of food, 
and subsequent ill-health. Vegetables and fruits are abso- 
lutely essential, but raw fruits are not so easily digested 
as cooked. Salads, lettuce, water-cress, green onions, 
celery, tomatoes, etc., are so valuable for the juices con- 
tained in them that they cannot be too strongly recom- 
mended to those who can digest them. Similar juices are 
contained in cabbage, cauliflower, spinach, etc., but these 
are lost to a very great measure in the cooking. 



THE DIGESTIVE SYSTEM 117 

Oranges, lemons, grapes, strawberries, and bananas con- 
tain equally valuable juices, and may be eaten raw with 
advantage to the consumer; but apples, pears, plums, 
gooseberries, and many other fruits are better cooked 
before being eaten. 

The simpler the meals, the less work will be expended in 
their preparation, and there is no advantage in an elabor- 
ate meal. The main thing is that the table should furnish 
a sufficient variety from day to day. 

The following specimen dietary has been found to be 
most satisfactory for women with sedentary occupations. 
On it women have maintained good health and other 
women have regained their health: 

Breakfast — Fruit, bacon and eggs, breakfast hominy, 
rolls or toast and butter, a glass of milk, and one cup of 
coffee. 

The fruit may be any raw fruit in season except apples 
or bananas; apples should always be cooked for breakfast 
because they are more easily digested; bananas are too 
heavy and indigestible to be served for breakfast. Stewed 
prunes are good and especially laxative. 

Bacon is not a necessity, though it is an appetizer. 
Eggs may be served in any way, though they are most 
digestible when soft boiled or poached. 

The hominy is boiled in water and served as a vegetable, 
with a little salt and butter, but no sugar. 

For women with good digestion and taking more active 
exercise, oatmeal and cream may be substituted for the 
eggs, hominy, and glass of milk. 

Luncheon may be served in a very appetizing way from 
the cold meat and vegetables which have been left from 
the previous day's dinner in the form of stews, baked hash, 
etc. Stewed fruit should always be served, and oysters 
always make a nice dish for lunch. 

The criticism of the ordinary lunch for women is that it 
is too light. The food served for lunch should furnish 
about 1000 calories; 90 per cent, of these should be in the 
form of starches and fats. 



118 PERSONAL HYGIENE FOR WOMEN 

Dinner. — The following is a balanced ration given in the 
Educational Lunch Room of the New York Department of 
Health: 

Proteins. 
Price. Quantity. Calories. Grams. 

Vegetable soup 5 cents. \ pint. 150 5 

Roast beef 20 cents. 4 oz. lean. 140 30 or 

Roast beef with 4 oz. fat. 460 27 

Mashed potatoes, 

creamed Av. helping. 110 4.0 

String beans 5 cents. 2 h. tbsp. 10 .5 

Salad a la Saute" 8 cents. Av. helping. 370 2.0 

Whole wheat bread 2 slices. 140 5.5 

Butter \ ounce. 120 

Apple pie 5 cents. \ pie. 300 -4.0 

Black coffee 3 cents. 1 cup. .... .... 

Sugar 2 squares. 60 

46 cents. 1760 or 50 or 
1440 53 



One glass of water is served with each meal; it should be 
taken when the meal is finished. 

The mineral waters promote digestion by promoting an 
earlier and more abundant secretion of the gastric juice. 

Lemon juice should be substituted for vinegar in all 
salad dressings. For a French dressing the correct propor- 
tions are 1 tablespoonful of lemon juice and water each 
to 2 of olive oil. Mix well, and pour over the salad just 
before serving. 

Three meals a day has been found to be the best ar- 
rangement, and there should be an interval of five hours 
between the meals. If possible dinner, which is the prin- 
cipal meal, should be taken at the end of the day, after its 
work is over, so that comparative repose may be enjoyed 
after it. It is of extreme importance that the meals be 
served at the same hour every day. The perfectly healthy 
woman should never take anything to eat between meals. 

A hearty meal should never be eaten when one is ex- 
hausted or greatly fatigued. Half an hour's rest before 
dinner is a great aid to digestion. Sleep directly after a 
hearty meal is injurious and sometimes proves fatal be- 



THE DIGESTIVE SYSTEM 119 

cause there is a depression of the circulation, and the 
digestive processes may stop absolutely during sleep. 

Preparation of Food. — Fresh meats are highly nutritious, 
but in order that the nutritive properties may not be lost 
in the cooking, they must be eaten "rare," that is, beef and 
mutton should be at least pink. 

A roast should be done in a quick oven, so that the al- 
bumin shall rapidly coagulate on the surface and prevent 
the escape of the nutritive juices. Or if the meat is 
boiled, it should for the same reason be plunged into boil- 
ing water. 

On the other hand, in treating meats in order to ob- 
tain "stock" for soup, the meat after having been cut up 
into small pieces should be allowed to stand in cold water 
for twenty minutes and then be put on to simmer for six 
hours or more. 

Plenty of bones with gristle should be gotten with the 
soup meat; these do not add to the cost, and add mate- 
rially to the value of the stock; for, while the gelatinoids 
are not flesh formers, they are admirable protein sparers. 
The same thing holds true of gelatin and its preparations. 

Indigestible Combination of Foods. — The acid of vinegar 
being a fermentation acid renders the digestion of many 
foods with which it is taken more difficult, while vegetable 
acids, such as citric and tartaric, do not cause that objec- 
tionable effect. Vinegar also retards salivary and gastric 
digestion. 

Strong tea taken with any meat meal converts the al- 
bumin of the meat into a dense precipitate that is abso- 
lutely indigestible. The tannin of tea inhibits the salivary 
and gastric secretions and so retards digestion. Indiges- 
tion, atony, or catarrh of the stomach is frequently due to 
excessive tea drinking, and the artificial stimulation of the 
nervous system may be carried so far as to produce in- 
somnia, palpitation, muscular tremors, and other signs of 
nervous irritability. 

Claret and coffee both delay digestion. 



120 PERSONAL HYGIENE FOR WOMEN 

Water is the best beverage to be taken with meals; but 
the moderate use of tea and coffee is commendable be- 
cause they have an invigorating effect arising from the 
caffein and the essential oils, but their use should not be 
abused. 

The Proper Way of Making Tea. — The water should be 
freshly boiled; the tea-pot heated so that the water will 
be maintained at the boiling-point; one teaspoonful of tea 
is allowed to the cup. The tea is measured out, put into 
the tea-pot, and the requisite amount of boiling water 
poured over it. It is then allowed to stand on the kitchen 
table, not the range, for from two to three minutes; it 
should then be strained into the tea-pot for the table. 

Unless the tea is strained off the leaves the infusion 
continues for some time; this extracts the tannic acid and 
bitter principles. In addition, the prolonged infusion dis- 
sipates the volatile oil, to which much of the fragrance of 
a good cup of tea is due. 

As it is almost impossible to have the requisite amount 
of care exercised in the making of tea in the kitchen, it is 
much better that it should be made on the table. Sugar 
detracts from the healthfulness of the beverage. 

Coffee. — Most that has been said about tea is true of 
coffee. It is aromatic and refreshing, stimulates the men- 
tal activity, invigorates the muscular system, and removes 
the sense of fatigue. The excessive use of coffee often leads 
to insomnia. Its use retards gastric digestion, but less so 
than tea; but strong coffee or cafe* noir has a still greater 
inhibitory effect. It has a slightly aperient effect on the 
intestines by increasing the peristaltic action. It is also 
slightly diuretic. 

The aromatic oils are dissipated by boiling, and the best 
temperature of the water is 210° F., or just below the boil- 
ing-point. 

Defective Methods in the Preparation of Breads which 
Reduces the Vitamin Contents, Especially of Corn Bread. — 
By resorting to artificial methods for procuring the light- 



THE DIGESTIVE SYSTEM 121 

ness of breads, baking soda (sodium bicarbonate) is used. 
In order to prepare bread in this way the cornmeal is 
mixed with milk or water to which baking soda has been 
added, and put in the oven to bake. The high temperature 
of the oven liberates the carbon dioxid (C0 2 ) from the 
baking soda, causing the bread to rise, and the sodium bi- 
carbonate is transformed into sodium carbonate, a strong 
alkali. Recent experiments have clearly demonstrated 
the destructive action of the alkalies on the vitamins, this 
being especially true at high temperatures. 

It should be strongly emphasized that the old-fashioned 
way of combining baking soda with sour milk in the prepa- 
ration of bread is an entirely harmless procedure, provided 
that sufficient sour milk is added to perfectly neutralize the 
alkalinity of the soda. The label on some brands of baking 
soda clearly states that sour milk, or tartaric acid, should 
be added in order to obtain the best results. 

Dietary in the Tropics. — Sir R. Havelock Charles says, 
"It is impossible to form exact rules for dietary in the 
tropics because there are differences in climate which re- 
quire modifications." He says nothing about limiting the 
amount of meat, but he does say, "no cold meat whatever 
should come on the table." It is important that every- 
thing should come straight from the fire to the table. It 
cannot then cause bacillary mischief, and there should be 
no fear of cholera or dysentery. 

Boiled water only should be drunk. No salads of any 
kind should be used except in the greatest moderation. 

Fruit — Every fruit which possesses a rind that can be 
removed may be eaten raw with impunity by a healthy 
man at any time of the year. Fruits which do not possess 
a rind are incapable of being thoroughly cleansed; such 
fruit may be contaminated and dangerousto the consumer, 
and, at any rate, ought only to be eaten after it is cooked. 
Therefore oranges, grape-fruit, pears, apples, bananas, 
mangoes, pineapples, custard-apples, mangosteen, toma- 
toes, etc., may be eaten raw after peeling them. But it 



122 PERSONAL HYGIENE FOR WOMEN 

would be unsafe to eat grapes, currants, strawberries, and 
other fruits which cannot be peeled until they are cooked. 

As regards proteins, some fish, fowl, or meat may be 
taken for breakfast; animal food ought not to be taken in 
the middle of the day. It is is better to take dinner in the 
evening. Beef, mutton, pork, kid (goat-flesh), venison 
(deer and antelope), poultry, many kinds of birds, eggs, 
and fish are obtainable in one place or another. Tinned 
meats and fish should be avoided; indeed, the importance 
of fresh meat is so great that hunting, shooting, and fish- 
ing should be strongly recommended as exercise. 

Fat is obtained in the form of meat, dripping, butter, 
ghee, nuts, and various oils used in cooking. The pure oil 
from peanuts, palm-nuts, and cocoanuts is salutary; but 
many samples are adulterated with sesame oil, poppy-seed 
oil, and colza oil, which are deleterious by causing dyspep- 
sia or other gastro-intestinal troubles. These in turn ren- 
der the subject susceptible to dysentery, sprue, and other 
tropical disorders. 

Food Economics : Regulation of Diet with Reference to 
Minimum Expenditure. — The cost of a meal for an indi- 
vidual or a family is made up of two factors — the money 
cost of the raw materials, and the time, cost of labor, and 
other expenses required for the preparation and serving of 
the food. 

The Cost of Raw Food Materials. — Meats of all kinds, 
poultry, and fish are the most expensive articles of diet. 
Then, too, the waste has to be considered — the bones and 
legs of a dressed fowl and the bones and skin of fish. 

At the present time the dairy products supply the cheap- 
est nutriment among animal foods, but the price of butter 
and eggs are apt to soar enormously during the winter 
months. 

Leguminous Food. — The dried pea, bean, or lentil are es- 
pecially rich in protein, and are thus fit to take the place of 
a part of meat in the dietary. Their price is low in com- 
parison to their value, and must be considered next to bread 



THE DIGESTIVE SYSTEM 123 

in importance. They are less completely digested than 
cereals if eaten in any quantity; and, highly nutritious as 
these are, it cannot be denied that in large quantities they 
are very indigestible for any but persons with strong con- 
stitutions and leading an active outdoor life. 

Great care is needed in their preparation. Dried leg- 
umes should be soaked in cold water for eight hours, and 
then boiled for one hour and a half. They are then suffi- 
ciently soft to be pressed through a sieve. The skin of 
peas and beans that have been dried should be removed, for 
they pass through the intestines unchanged. Soft water 
should be used in preference to hard, as insoluble lime com- 
pounds are formed by the latter with the protein "legu- 
min. ,, 

Outside Preparation Expensive. — From the standpoint of 
food value, white bread is more than twice as costly as the 
wheat flour from which it is made. A barrel of flour of 196 
pounds will make on the average 315 5-cent loaves of 
bread. The bread costs the consumer $15.75, whereas the 
flour can be bought at the time of writing for $6.50. 

Breakfast foods ready for the table, instead of the 
cheaper cornmeal, oatmeal, and hominy cooked at home, 
and bread, cake, and other pastry cost double the amount 
of the raw materials. 

There are, however, other factors which complicate and 
increase the cost of living. At present the exorbitant cost 
of labor, cost of fuel, etc., and the amount of the house- 
wife's time consumed are all important factors to be taken 
into consideration. 

The size of the family, the number of small children de- 
manding the mother's attention, the kind of labor in which 
they are engaged, whether hired help has to be depended 
on for all the work, etc., are all factors which must be taken 
into consideration as to whether the outside preparation is 
more expensive than when the labor is performed in the 
home. This is a matter for every housewife to work out 
in making her monthly and yearly budgets. 



124 



PERSONAL HYGIENE FOR WOMEN 





TABLE OF FOOD VALUES i 










Percentage composition. 


Heat 
value 

calories 
per 

ounce. 


Food 
values 


Kind of food, edible 
portion only. 


Water. 


Protein. 


Fat. 


Carbo- 
hydrate. 


Ash. 


com- 
parison 
of 1000 
grams. 


Meats. 
Beef: 


48.25 
45.20 
39.10 
44.25 
51.19 
51.88 

51.00 

57.67 

67.10 

47.25 
45.00 

62.60 
76.15 
71.00 

71.00 

71.00 

93.00 
96.50 
94.00 
95.50 
80.00 
84.50 
89.00 
87.00 
89.10 
89.00 
90.00 

64.00 
67.00 
56.00 
55.75 
52.00 
55.50 
52.00 
59.00 
66.90 
57.60 

73.70 
86.30 
50.00 

78.50 
81.40 


22.25 
19.14 
26.30 
23.45 
26.32 
32.20 

26.00 
27.60 

19.70 
23.80 
32.00 

16.60 
16.50 
20.60 

16.80 

19.00 

4.30 
2.30 
3.80 
2.40 
6.50 
4.60 
4.00 
4.00 
5.80 
2.00 
5.37 

19.00 
22.70 
21.80 
17.50 
16.50 
21.10 
27.80 
27.00 
22.00 
27.00 

13.40 
12.80 
14.80 

19.10 
17.20 


28.55 
39.04 
35.00 
26.50 
18.65 
11.40 

22.60 
14.38 

12.70 
28.50 
20.00 

20.00 
4.90 
4.60 

12.00 

9.00 

.50 
.10 

.10 

.10 
2.00 
4.30 
1.50 

.80 
1.50 
1.50 

.19 

16.00 
10.00 
21.00 
25.00 
35.10 
23.00 
18.50 
11.50 
8.10 
12.80 

11.50 

.20 

33.70 

1.20 
.30 


".40 
1.80 

1.10 
.20 
1.80 
.30 
9.00 
5.50 
4.30 
8.50 

5.50 


1.25 

.82 
1.00 
1.43 
4.10 
1.50 

1.19 
1.05 

.80 
1.25 
1.76 

1.00 
1.20 
1.50 

1.60 

1.00 

1.10 
.90 
1.00 
1.10 
2.40 
1.10 
1.50 
1.30 
3.60 
1.30 
1.36 

1.00 
1.00 
1.30 
1.00 
1.20 
1.00 
1.30 
1.30 
1.70 
1.90 

1.00 

.70 

1.20 

1.20 
1.10 


160 

122 
175 
100 
80 
68 

90 
67 

66 
100 
90 

70 
32 
38 

51 

46 

8 
3 
6 
3 

24 
23 
13 
15 
11 
12 
7 

65 
62 
91 
95 
110 
85 
82 
60 
58 
80 

45 
16 
106 

27 
21 


1868 




2057 




2268 




1942 




1810 


Veal: Cooked, average 

Mutton: 


1896 
1805 




1738 


Lamb: 


1318 




1966 


Pork: Roast, various parts . . 

Organs: 

Heart, cooked, average 

Kidney, ox, cooked, average 
Liver, ox, cooked, average. 
Sweetbread, ox, cooked, 


2122 

1370 
940 
1150 

1157 


Tongue, ox, cooked, aver- 


1188 


Soup, etc. 


234 




116 




200 




120 




560 




420 




278 




291 




324 




158 


Meat juice (natural), average 
Fowl. 


269 
1130 




1395 




1656 


Duck 


1554 




1800 


Turkey 


1679 




1872 




1677 




1298 




1708 


Eggs. 
Chicken eggs: 

Raw 


983 




633 


Yolk 


1883 


Fish and Shell-fish. 


935 


Haddock, fresh 


922 



1 Compiled from Tibbies' "Dietetics, or Food in Health and Disease. 



THE DIGESTIVE SYSTEM 



125 



Kind of food, edible 
portion only. 



Fish and Shell-fish. 

Halibut steak 

Mackerel 

Oysters 

Perch 

Salmon, Atlantic 



Shad 

Roe 

Trout: 

Brook 

Lake 

Salmon 

Calf's foot jelly. 



Milk Products. 

Cows' milk, average 

Skimmed 

Condensed milk, full cream, 

unsweetened 

Full cream, sweetened.. . 
Skimmed and sweetened, 

Cream, hand skimmed 

Buttermilk 

Cheese from skimmed milk. . 
Butter: 

Best quality 

Second quality 

Margarine 



Cereal Foods. 
Wheat flour, superfine, white 

Entire wheat 

Graham 



Meal 

Rice 

Boiled.... 

Oatmeal, boiled . . 
Macaroni, cooked. 

Bread. 

White, best 

Entire wheat 

Brown (Graham). 

Gluten bread 

Toasted bread — 
Zwiebach 



Pies and Puddings. 

Apple pie 

Cornflour blanc mange 

Custard with crust 

Maize pudding (Indian meal) 

Rice pudding. 

Tapioca pudding 

With apples 



Roots and Tubers. 
Carrots, boiled 



Percentage composition. 



Water. 



74.80 
74.80 
80.00 
75.70 
63.60 
56.30 
70.60 
71.20 

77.70 
69.30 
70.80 
77.50 



87.30 
90.30 

62.40 
20.00 
26.40 
74.00 
90.00 
45.30 

13.00 
16.00 
16.00 



10.50 
10.80 
8.60 
10.90 
12.50 
12.40 
72.50 
84.50 
78.40 



44.10 
49.10 
47.20 
38.20 
24.00 
5.80 



42.50 
66.00 
62.40 
60.00 
60.00 
64.50 
70.10 



92.50 



Protein. 



18.50 
18.50 
10.60 
19.00 
21.60 
24 80 
18.50 
21.00 

19.30 
18.30 
17.80 
4.50 



3.50 
4.00 

10.60 
10.50 
10.40 
2.50 
3.20 
32.00 

1.00 
2.00 
1.10 



11.90 
12.20 
12.60 
10.20 
7.10 
6.90 
2.80 
2.80 
3.00 



7.70 
7.40 
7.70 
9.30 
11.50 
9.80 



3.10 
2.60 
4.20 
5.50 
4.00 
3.30 
.30 



.50 



Fat. 



5.30 
6.50 
2.60 
4.00 
13.90 
12.70 
9.50 
3.80 

2.10 
10.60 
10.20 



3.70 
.20 

10.80 

9.90 

.90 

18.50 
1.20 

16.50 

82.50 
73.00 
76.70 



1.60 

2.20 

2.40 

4.80 

1.30 

.40 

.10 

.50 

1.50 



.90 
1.10 
1.20 
1.40 
1.60 



3.10 
6.30 
5.00 
4.70 
3.20 
.10 



.20 



Carbo- 
hydrate. 



6.50 



2.50 



17.40 



4.60 
4.60 

14.10 

57.50 

60.20 

4.50 

5.00 

2.00 

1.50 

4.00 



75.40 
73.60 
74.50 
71.00 
78.30 
79.40 
24.50 
11.50 
15.80 



46.90 
41.70 
42.80 
49.80 
61.20 
73.50 



43.00 
27.00 
26.10 
28.00 
32.00 
28.50 
30.00 



4.50 



Ash. 



1.40 
1.10 
1.30 
1.20 
1.40 
5.00 
1.30 
1.50 

1.20 

1.20 

1.20 

.70 



.73 



2.00 
2.10 
2.10 
.50 
.60 
4.20 

2.00 
5.00 
6.30 



.50 

1.00 

1.70 

1.30 

.60 

.50 

.20 

.70 

1.30 



.30 

.50 

.90 

1.30 

1.70 

1.00 



1.80 

1.00 

1.00 

1.40 

.60 

.80 

.20 



Heat 

value 
calories 



20 
11 

52 

100 
40 
56 
10 
85 

225 
203 



114 

114 
116 

ios' 

102 
45 
18 
26 



71 

65 
67 
72 
90 
125 



Food 
values 

com- 
parison 
of 1000 
grams. 



850 
1086 

655 
1049 
1445 
1560 
1170 
1252 

995 
1190 
1156 

210 



320 
245 

973 
1368 
1232 
210 
238 
2140 

2371 
2235 
2210 



1283 
1300 
1330 
1242 
1106 
1084 
258 
244 
558 



793 
770 



910 
1126 



456 
604 
628 
608 
505 



70 



126 



PERSONAL HYGIENE FOR WOMEN 

TABLE OF FOOD VALUES (Continued). 



Kind of food, edible 
portion only. 



Percentage composition. 



Water. 



Protein. 



Fat. 



Carbo- 
hydrate. 



Ash. 



value 
calories 



Food 
values 

com- 
parison 
of 1000 
grams. 



Roots and Tubers. 

Beets, boiled 

Parsnips, boiled 

Potatoes, boiled 

Mashed, with cream . 

Fried in fat 



Vegetables. 
Asparagus, cooked and but- 
tered 

Brussels sprouts, boiled 



Boiled 

Cauliflower, boiled. . . 

Celery, boiled 

Green peas, boiled. . . 
3, string, boiled . 



Salads. 



Celery. 
Cucumber. 
Endive — 
Lettuce — 
Onions 



Tomatoes. . 

Watercress. 



Dried Legumes. 



Haricot beans. 
Butter beans. . 



Nuts. 

Almonds, dried 

Brazil nuts 

Butter nuts 

Chestnuts 

Cocoanut, fresh 

Hazel and filbert nuts. 

Peanuts 

Walnuts, dried 



Fruits. 
Apples: 

Raw 

Cooked and sweetened . 

Dried 

Apricots 

Canned 

Bananas.. 

Blackberries 

Cherries 

Cranberries 

Dates, dried 

Figs, dried 

Grapes, fresh 

Dried, raisins 

Jam, or preserve, average. 



91.70 
92.10 
75.50 
75.10 
2.20 



91.60 
93.70 
85.50 
97.00 
97.30 
97.00 
73.80 
89.20 



94.50 
94.90 
93.00 
93.80 
87.60 
91.80 
91.80 
92.80 



9.50 
12.60 
10.50 



4.80 
5.40 
4.50 
4.80 
19.20 
48.00 
9.20 
4.90 



85.20 
66.10 
28.10 
85.00 
81.40 
75.70 
86.30 
82.00 
88.90 
20.00 
22.70 
80.50 
18.60 
30.50 



1.40 
1.30 
2.50 
2.60 
6.80 



2.10 
1.50 
2.30 



.40 
6.70 
2.30 



1.10 
.70 
1.00 
1.80 
1.60 
1.20 
1.20 
.70 



23.80 
22.50 
20.60 



21.00 
18.00 
28.00 
11.60 
5.40 
8.00 
26.00 
15.50 



.40 

.20 

1.60 

1.10 

.90 

1.30 

1.30 

.90 

.50 

3.50 

4.30 

.90 

3.00 

1.50 



.10 

.30 

.10 

3.00 

39.80 



3.30 
.10 
.70 
.10 
.10 
.07 

2.50 
.30 



.10 
.20 
.10 
.60 
.30 
.10 
.10 
.40 



1.80 
1.90 
2.00 



54.90 
66.00 
61.00 
15.30 
51.00 
28.50 
38.60 
62.70 



.50 

1.00 

.80 



.70 
.80 



5.13 
6.50 
21.00 
17.80 
46.70 



2.20 
3.40 
5.10 
1.40 
1.40 
1.00 
14.60 
7.40 



9.70 
3.10 
3.00 
4.80 
9.50 
5.60 
5.60 
4.00 



60.30 
59.60 
62.60 



17.30 
8.00 
3.50 
65.70 
10.00 
11.50 
24.20 
7.50 



12.60 
37.20 
66.10 
13.40 
17.30 
21.70 
8.40 
14.30 
4.00 
69.00 

'62.50 
14.70 
70.50 

[60.00 



1.00 
.70 
1.00 
1.50 
4.50 



.20 
1.70 
.20 
.50 
.50 
1.50 
.80 



1.00 
.50 
.60 

1.20 

1.10 
.70 
.70 

1.20 



2.60 
3.50 
4.20 



2.50 
2.70 
2.90 
2.60 
1.20 
1.50 
2.00 
1.90 



.30 
.70 

2.00 
.50 
.40 
.70 
.50 
.60 
.20 

1.30 

1.30 
.50 

2.70 



31 
166 



104 
100 
102 



189 
204 
192 
117 
108 
160 
160 
190 



18 
46 
84 
18 
21 
29 
17 
23 
14 

101 
80 
28 

100 
70 



126 
312 
364 
1807 



200 



41 

41 
26 

588 
176 



144 
64 
73 
138 
167 
107 
107 
79 



1544 
1654 
1519 



2645 
2606 
2956 
1537 



2071 
2364 



149 
395 
753 
176 
208 
276 
120 
197 
76 
885 
805 
201 
870 
744 



THE DIGESTIVE SYSTEM 



127 





Percentage composition. 


Heat 
value t 

calories 
per 

ounce. 


Food 


Kind of food, edible 
portion only. 


Water. 


Protein. 


Fat. 


Carbo- 
hydrate. 


Ash. 


com- 
parison 
of 1000 
grams- 


Fruits. 
Melon 


89.50 
82.80 
88.80 
88.10 
80.90 
81.10 
89.30 
74.50 

22.30 
76.60 
86.20 
94.00 


.60 
.90 
.50 
.70 
.90 
.30 
.40 
.90 

2.10 
.50 
.50 

1.00 


.30 
.20 
.20 
.10 
.50 
.30 
.30 
.20 

.20 
.10 

' '.60 


7.20 
10.60 

9.20 
10.80 
15.70 
18.00 
10.00 
19.10 

73.30 

22.30 

5.60 

8.80 


.60 
.70 
.60 
.30 
.40 
.30 
.90 
.50 

2.30 
.50 
.50 

.60 


11 

15 
12 
14 
18 
22 
13 
24 

86 
27 
16 
12 


103 




146 
117 
128 
203 
195 
112 














200 

724 
243 


Prunes: 
Dried 


Stewed 


Raspberries 


76 


Strawberries 


144 







The Physiologic Action of Moderate Doses of Al- 
cohol. — The result of a series of experiments by Dr. 
Parke were as follows: "By quickening the action of the 
heart, it shortens the interval of rest, and, therefore, in- 
terferes with the nutrition of the heart. It also produces 
palpitation and breathlessness. Even small doses of 
alcohol, by increasing unnecessarily the action of the heart, 
are injurious. It acts on the nervous system by lessening 
the rapidity and the delicacy of the impressions, as well as 
by lessening the power of control of a train of thought. 
Further, by this same blunting of the nervous system, 
voluntary muscular power is impaired, and the finer 
combined movements are less perfectly made. It causes 
a lowering of the temperature of the body, and, although 
it is taken to overcome the effects of exposure to cold, it 
has been learned that persons who take it are less able to 
resist the exposure to cold." 

As the result of modern scientific investigation and ex- 
perimentation, alcohol with its compounds has been taken 
out of the list of beverages, where it has heretofore been 
classified with tea and coffee, and out of the list of foods, 
to which class it had been admitted because of the known 
oxidation of alcohol in the body, and has been placed in 
that list of drugs known as narcotics, alongside of ether, 



128 PERSONAL HYGIENE FOR WOMEN 

chloroform, opium, and cocain — all of them, the most 
deadly drugs in the Pharmacopeia, yet, when used by 
skilled hands, the most beneficent. 

The first effect of this class of drugs is a short temporary 
stage of exhilaration, more or less rapidly followed, ac- 
cording to the amount taken, by a stage of sleepiness or 
actual insensibility, which lasts longer than the stage of 
excitement, and this in turn is followed by a long period of 
depression. 

Like other members of its class, alcohol has a cumula- 
tive action, the residual quantities habitually taken ac- 
cumulate and gradually affect the efficiency and well- 
being of the individual. 

A point that must always be borne in mind in giving 
any medicine is that not a few drugs have a curious ten- 
dency to induce a craving for their repetition. 

The amount of alcohol contained in some of the most 
commonly used of the alcoholic beverages is as follows: 
beer, 4 to 5 per cent. ; hard cider, from 5 to 10 per cent. ; 
claret, 8 to 11 per cent. ; port, 9 to 22 per cent. ; champagne, 
10 to 15 per cent. ; rum, gin, and strong liquors, 40 to 50 
per cent.; whisky, 44 to 50 per cent.; brandy, 48 to 56 
per cent. 

These alcoholic beverages are often made still more 
harmful by adulterations by ingredients in themselves 
harmful. 

A large percentage of alcohol is also found in bitters 
and patent medicines. 

We will consider the subject of alcohol under the fol- 
lowing aspects: First, the question of alcohol as a food; 
second, the effects of alcohol on the digestive system and 
the metabolism; third, the effects of alcohol on the heart 
and the muscular system; and fourth, the effects of alcohol 
on the nervous system. 

First, Is Alcohol a Food? — The substances used as foods 
act in providing energy for muscular work, in maintaining 
the heat of the body, in building up of the tissues, and in 
saving the waste of the tissues. Moreover, a food which 



THE DIGESTIVE SYSTEM 129 

does harm to any organ, or to the system as a whole, 
when taken in moderate repeated quantities, becomes a 
poison for that individual. 

A food may be defined as any substance which, when 
absorbed into the blood, will nourish, repair waste, and 
furnish force and heat to the body, without causing 
injury to any of its parts or loss of functional activity. 
From any one of these four standpoints alcohol cannot be 
regarded as a food. 

The physiologic effects of alcohol and real food-stuffs 
are totally different. Fats, carbohydrates, and nitroge- 
nous foods after mastication at once begin to be digested 
and assimilated, and to fulfil the true functions of a food 
by maintaining a natural temperature, pulse-rate, and 
tissue repair of the body, without any disturbance of its 
mental and physical functions and activities. 

Alcohol, on the contrary, is absorbed from the stomach 
unaltered by the digestive processes; circulated in the 
blood in its original form, it at once interferes with the 
ordinary activity of the brain and other organs, and, 
by its anesthetic action, hampers the mental and phys* 
ical activities and interferes with the processes of meta- 
bolism. 

The Effects of Alcohol on the Digestive System and 
Metabolism. — The local action of alcoholic liquids is 
particularly destructive on an empty stomach; and when 
taken in strong solution, but it is also known that smaller 
doses, taken continuously, are liable to effect the digestive 
organs in a slower though similar way. 

The injurious effects of alcohol are that it acts as a local 
irritant, producing dilatation of the blood-vessels of the 
stomach and subsequent gastritis; it leads to hyperacidity, 
by stimulating the secretion of hydrochloric acid; the 
tartrates and malates contained in wine are decom- 
posed in the stomach, setting free organic acids, and 
thus producing acidity; the acetic acid and yeast in 
beer set up an acetic acid fermentation in the stomach- 
contents. 



130 PERSONAL HYGIENE FOR WOMEN 

Whether taken alone or with food, the tendency of alco- 
hol throughout is to lessen the churning movements of 
the stomach, and leads to atony of that organ, which 
in turn leads to dilatation of the stomach. 

Alcohol appears to have a particularly deleterious effect 
on the digestion of women. This is explained by the fact 
that men lead a more active outdoor life, and consequently 
retain their appetite for food longer than women. For 
the same reason, they are able to work off the effects of 
drinking more easily and start afresh the assimilation of 
food. The indoor life led by women, their clothing, 
worn tight around the stomach, are added causes for 
lack of appetite. Catarrh of the stomach results; this is 
followed by insufficient food and an increased amount 
of stimulants. There follow nausea, irregular and insuf- 
ficient nutrition, indigestion, and a faulty elaboration of 
the food. 

By its action on the liver alcohol interferes with the 
amount and quantity of bile, and so inevitably leads to 
indigestion and constipation, and a similar interference 
with the action of the liver-cells and their chemical 
changes set up in many cases gouty conditions, accom- 
panied by mental depression and irritability. 

Diseases of the liver occur more frequently as the result 
of taking frequent small doses of alcohol, though never 
reaching the stage of intoxication, than as the result of 
indulging more freely, but at longer intervals. 

The Effect of Alcohol on the Blood. — The blood is a mix- 
ture of corpuscles and a fluid known as the blood plasma. 
The corpuscles are of two kinds — red and white. The red 
blood-corpuscles are the oxygen carriers; they carry the 
oxygen to the tissues, where they readily give it up. They 
are constantly being destroyed by the liver and spleen, 
and are replaced by new ones, which come from the red 
marrow of bones. The white corpuscles are much fewer 
in number, but they play a most important part in pro- 
tecting the body against disease. It is now about twenty 
years since Professor Metchnikoff, of the Pasteur Institute 



THE DIGESTIVE SYSTEM 131 

of Paris, announced to the world his discovery that the 
white corpuscles have the power of destroying the mi- 
crobes to which so many diseases are due. These white 
blood-cells form the standing army or policemen of the 
body, and their duty is to attack, and, if possible, to 
destroy, any foreign matter, such as dust or disease 
germs. 

The plasma of the blood contains various kinds of salts, 
and include sodium chlorid or common salt, the phos- 
phates, and chlorids of calcium and potassium. 

The way which the body fights disease is partly by means 
of the white blood-corpuscles, which totally destroy the 
germs, and partly by the increase in the blood of those 
chemical substances which are antidotes for the poisons 
given out by the germs. 

Alcohol taken into the stomach is quickly absorbed and 
reaches the blood in two minutes. The maximum of 
alcohol is found in the blood in fifteen minutes after it is 
swallowed. 

The blood is the medium by which food and oxygen are 
conveyed to the tissues, and by which the refuse material 
from the tissues is carried away; alcohol interferes with 
both these processes. 

The red cells are liable to become damaged and anemia 
results. It has now been proved that even tiny doses of 
alcohol paralyze more or less the white cells, and thus in- 
terfere with their power of destroying microbes. Chemi- 
cal substances tend to exert a delaying or inhibitory in- 
fluence over the chemical processes of the body. These 
chemical processes are oxidation, the storing up of nutri- 
ment, the manufacture of secretion, the production of 
energy and muscular movement, and the excretion of 
waste materials. 

The greatest possible difference exists as to the rate at 
which oxidation goes on. When there is nothing to hinder 
its occurrence, the poisonous toxins and waste matters 
are rapidly burned up and eliminated and health prevails. 
Alcohol, by its affinity for oxygen, robs the tissues of 



132 PERSONAL HYGIENE FOR WOMEN 

oxygen which they would otherwise use for combustion. 
Hence the tissues are kept starving for oxygen, metabo- 
lism is interfered with, and they cannot get rid of their 
waste material. 

This delayed oxidation tends to increase the body 
weight. The cells in an intermediate stage of fatty degen- 
eration clog the body, and, of course, add to its weight. 
The natural effect of taking alcohol is to make the body 
obese. On abstaining from alcohol, the superfluous 
tissue is often burned away, and the weight of the body 
reduced, and a look and feeling of youth is recovered. 

The Effect of Alcohol on the Heart and Circulation. — By 
the circulation we understand the driving of the fluid 
blood around the body, through the blood-vessels, such 
driving being maintained by the pumping power of the 
heart, which is practically a hollow muscle. 

In consequence of this pumping power of the heart, the 
blood in the vessels is under considerable pressure, which 
is naturally increased if the blood-vessels are narrowed 
or contracted, and diminished if the blood-vessels are 
expanded or dilated. 

Gradual deterioration in the heart power is a cause of 
premature death. One of the early indications that the 
foregoing changes may be occurring in a heart is a sense 
of fatigue and breathlessness on slight exertion, or a 
feeling of disinclination for normal effort. The result of 
such depression of the efficiency of the heart is often seen 
when the individual is attacked by some disease; she 
succumbs to heart failure, instead of being able to resist 
the disease. This probably accounts for a great many 
deaths between forty and sixty years of age. 

Further, it must be remembered that all the nutritive 
action of the blood depends on its power of rapidly 
filtering through the walls of the blood-vessels to the 
tissues, and, conversely, its power of drawing off the 
waste-products of the tissues depends on the facility with 
which such products can penetrate its walls. 

As soon as degeneracy sets in, the walls of all vessels 



THE DIGESTIVE SYSTEM 133 

tend to become thickened, and the active transference 
through them, more and more prevented; the nutrition 
of the body is thus gravely hampered, and, with the 
advance of this thickening of the walls, the vessels are less 
able to adjust themselves to the variations in pressure 
from within; and, finally, when unable to withstand the 
pressure, they rupture, causing hemorrhage and apoplexy, 
which, when occurring in the brain, cause paralysis and 
mental decay. 

A similar degeneration takes place in old age, but the 
point is, that many persons, instead of waiting until old 
age comes to them, deliberately precipitate these senile 
changes. 

The Effect of Alcohol on the Kidneys. — The elaborate 
mechanism of the kidneys consist of a filtering system of 
thousands of tubules, arranged closely side by side, whose 
function it is to carry away from the body the waste 
material, which otherwise would interfere with the vitality 
of the different organs. 

The part played by the kidneys in rapidly eliminating 
effete material cannot be too carefully safeguarded. 
Anything which interferes with its work will sooner or 
later cause a retention of waste-products in the system, 
and will also permit of the escape of valuable albuminous 
materials of the substance of the blood through the filter- 
ing apparatus. The effect of alcohol upon the kidneys 
can only be described as disastrous. In proportion 
as the kidney shrinks, there is a diminution of the excre- 
tion of urine, and, finally, the condition known as Bright's 
disease is established. 

The Effect of Alcohol on the Muscular System. — The 
muscular tissue forms 43 per cent, of the body weight. 
It has been proved that under the moderate use of alcohol 
the muscles become flabby and less vigorous and effective; 
that troops cannot work or march on alcohol; that in 
training for athletics, for races, or for other sports, total 
abstinence is always practised; the true sportsman de- 
pends quite as much on his brain as on his muscles for 



134 PERSONAL HYGIENE FOR WOMEN 

success. In England it is recognized that total abstinence 
is a necessity where great exertions are concerned, and it 
is now beyond all question that alcohol, in even so-called 
dietetic quantities, diminishes the output of muscular 
work, both in quantity and quality, and that the best 
physical results are obtained under total abstinence from 
its use. 

Alcohol actually lowers the temperature of the body 
from three-fourths of one degree to three degrees. This 
depression of temperature is not transient, but lasts for 
several days, so that its use, when the person is exposed 
to intense cold, is extremely hazardous to life. 

The Effects of Alcohol on the Nervous System. — Kraepelin 
has carried out a series of experiments to prove the effects 
of small doses of alcohol on the output of work. In all 
mental work there are two elements to be considered, 
namely, quality and speed. Now, all observers are 
agreed that the quality of mental work is affected even 
before speed, more mistakes being made. Tests were 
made in reading aloud; in adding figures in various com- 
binations; in type-setting; and in memorizing; in all 
these instances it was found that, after taking moderate 
doses of alcohol for a number of consecutive days, the 
work done was less, was less accurate, and that there 
was a decrease in the power of memorizing. 

Another series of investigations, made by Rudin to 
determine how long the intellectual abilities continue to 
be depressed after the effects of alcohol pass off, showed 
that the effects of a single dose of alcohol persisted until 
noon or evening of the next day. 

Von Helmholtz, one of the greatest observers and 
thinkers of the nineteenth century, noted on himself the 
effect of alcohol in interfering with the highest powers 
of thought and conception. Describing the conditions 
under which his highest scientific thoughts had matured 
and come to fruition, he said: "As far as my experience 
is concerned, they never come to a wearied brain or at the 
writing-desk; they were especially inclined to appear to 



THE DIGESTIVE SYSTEM 135 

me while indulging in a quiet walk in the sunshine or 
over the forest-clad mountains, but the smallest quantity 
of alcohol seemed to drive them away." 

Professor Sikovsky's testimony is that " alcohol dimin- 
ishes the rapidity of thought, makes the imagination and 
the power of reflection commonplace and deprived of 
originality, acts upon fine and complex sensations by 
transforming them into coarse and elementary ones, 
provokes outbursts of evil passions and dispositions, and in 
this predisposes men to strife and crime, and upsets 
habits of work and perseverance." 

Self-control is one of the highest functions of the brain, 
and the racial power which results to a people as a conse- 
quence of the individual practice of self-control cannot be 
too highly estimated. Therefore, children are trained as 
far as possible to control their emotions and actions. 
Alcohol diminishes and breaks down this power of ac- 
quired self-control, undoing the work of parents and 
educationalists. Quite small doses are often responsible 
for reckless and self-pleasing actions, which are far 
reaching in their results in loss of moral tone and self- 
respect. The ideals of duty are lost sight of, and, at best, 
leave the individual in a laissez-faire attitude. Among 
the depressant effects of alcohol are intellectual lethargy 
and a sense of fatigue, which, combined with the other 
factors, lessen the capacity for genuine enjoyment and 
pleasure. 



CHAPTER V 

THE RESPIRATORY AND CIRCULATORY SYS- 
TEMS: THE KIDNEYS 

The Mechanics of Circulation and Respiration; the Circulatory 
Apparatus; the Lungs; Hygiene of the Lungs and Its Relation to the 
General Health; Relation of Respiration to Body Heat; the Res- 
piratory Functions of the Abdominal Muscles; the Importance of 
Good Chest Development; Proper Relation Between the Height, 
Weight, and Chest Measurements; Chemical Properties of Air; 
Town and Country Air; Dust and Its Relations to Disease; Role 
Played by Bacteria; Ventilation; the Injurious Effects of Overheated 
Air; the Proper Degree of Moisture for the Air of the House; Ventila- 
tion of Bed-rooms. 

Care of the Nose, Throat, and Ears; Impediments to Respiration; 
Ventilation of the Lungs and Breathing Exercises; Cure of Chronic 
Bronchitis by Deep Breathing Exercises; Relation of Colds to 
Pneumonia and Tuberculosis, and Their Prevention. 

The Kidneys and Their Function; the Physiology of the Female 
Pelvic Organs. 

It is said that diseases of the lungs are the cause of 
four-fifths of all indispositions, ill health, and actual 
disease among civilized people, and that, between the 
age of fifteen and twenty-five, almost one-half of the 
mortality is due to pulmonary tuberculosis. 

This almost universal weakness of the lungs, as it may 
be styled, is a product of modern civilization, and is 
caused by our unhygienic mode of life. Too little im- 
portance is attached to physical development, and well- 
developed lungs can only be found in a well-developed 
chest; too little time is spent in outdoor exercise; and 
private houses, public conveyances, and public assembly 
rooms are not properly ventilated. 

Good development of the chest and lungs, and thorough 
and systematic ventilation of the lungs, are essential to a 
strong heart, a vigorous circulation, and power of the 
tissues to resist disease. 

137 



138 



PERSONAL HYGIENE FOR WOMEN 



The Mechanics of Circulation and Respiration. — 

In order to understand the mechanics of circulation and 
respiration, it is necessary to appreciate four funda- 
mental facts — that the thorax is a distensible, air-tight 
cage; that it contains and is filled by the heart, lungs, 
and great blood-vessels ; that the exchange of gases in the 
blood takes place in the lungs; and that, on the develop- 
ment of the chest and respiratory muscles, depend the 
development of the lungs and the force of the circulation. 




F bating ribs 
Fig. 7. — The bony thorax, anterior view (Ingals). 



The Thorax. — The chest or thorax is a cone-shaped, 
distensible cage, formed of bones, elastic cartilage, and 
muscles. The spinal column forms the fixed part of this 
living cage, and the ribs are attached to this in such a 
way as to allow of their being raised in inspiration, thus 
increasing the anteroposterior and the lateral diameters 
of the chest. 

The thorax is converted into an air-tight cavity by 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 139 

means of muscles. The base is made up of one huge 
muscle, the diaphragm. This is attached at its border to 
the ribs and posteriorly to the backbone. It is the dia- 
phragm which separates the cavity of the thorax from that 
of the abdomen. When the diaphragm is relaxed, it has 
a concavoconvex form, the convexity being directed 
toward the chest, and the heart and lungs rest directly 
on it, while the concave surface covers or rests on the 
liver. 

The Circulatory Apparatus. — This consists of a central 
force and suction-pump, the heart, and a series of elastic 
tubes that grow smaller the further from the heart they 
are situated; they divide and subdivide, like the branches 
of a tree. The smallest arteries, called capillaries, from 
their hair-like size, are so minute that they only allow 
the passage of a single corpuscle at a time and their walls 
are transparent. 

The heart is a somewhat cone-shaped organ, placed 
between the two lungs ; it is situated more or less obliquely 
in the chest, immediately back of the breast-bone. 
Roughly speaking, the base of the heart corresponds to 
the right edge of the sternum, while the apex lies a little 
below and to the right of the left nipple. 

The heart is divided into a right and left side. The 
left side forms the force pump, whose motive power is 
supplied by the contraction of its own muscle-fibers. 
The bright red blood, with its fresh supply of oxygen — 
hence its color — flows from the lungs into the left heart, 
which then contracts automatically and forces the blood 
into the arteries of the body. 

The arteries consist of a series of elastic tubings ; hence, 
the smaller the tubing, the greater the resistance which 
has to be overcome by the force of the heart's beat, so 
that during violent exercise, when the contraction of the 
muscles causes a pressure on the minute arteries and 
capillaries situated in them, the more forcible must be the 
beat of the heart to overcome this additional resistance. 
Likewise, when the surface of the body is suddenly 



140 



PERSONAL HYGIENE FOR WOMEN 



chilled, as by a plunge into cold water, .all the vessels 
situated here contract, and, again, more work is thrown 
on the heart. 

The three chief factors in the mechanics of the circula- 
tion are the force and frequency of the heart's beat, the 
peripheral resistance, and the elasticity of the arterial 
walls. Any disturbance between these relations brings 
about abnormal conditions. 



Larynx 



Right common 

carotid artery 

Subclavian 

arteries 

Innominate 

artery 

Arch of aorta 
Right lung 

Superior vena 
cava 

Right auricle 




Heart 

Coronary 
artery 



Fig. 8. — Front view of heart and lungs, showing relations to other 
thoracic organs (Ingals). 

The average frequency of the heart's beat, or the pulse, 
is 72 times a minute. It is increased by exercise; it is 
quicker in the standing than in the sitting posture. It 
is quickened by meals, and, on the whole, it is quicker 
in the evening than in the early morning hours. Inde- 
pendent of muscular exertion, it is quickened by great 
altitudes. It is said to be quicker in summer than in 
winter. Its rate is profoundly influenced by mental con- 
ditions. 



THE KESPIRATORY AND CIRCULATORY SYSTEMS 141 

The whole of the blood of the body passes through the 
heart in 32 beats — that is, in less than half a minute. 
The greatest part of this time is spent in the capillaries, 
There the tissues are obtaining their fresh supplies of food 
and discharging their waste matter into it. 

The heart, great blood-vessels, and the lungs are placed 
in the air-tight cavity of the thorax, and are subjected to 
the pumping action of the respiratory movements. The 
inspiratory muscles elevate the ribs, at the same time that 




Fig. 9. — Relation of heart and great vessels to the wall of the thorax. 
The collapsed lungs are drawn slightly aside (after Heath). 

the diaphragm, by its contraction, pushes the contents of 
the abdomen downward. The cavity of the chest, so 
enlarged, causes the pressure around the heart and the 
great blood-vessels within the chest to be less than that 
on the blood-vessels outside the chest ; hence, during each 
inspiration the venous blood is sucked back into the right 
side of the heart. 

The tissues deprive the blood of its oxygen, so that which 
flows back to the heart in the veins is blue. The right 



142 PERSONAL HYGIENE FOR WOMEN 

heart then sends this blue blood to the lungs, that it may 
get rid of its carbonic acid, which is not only not needed, 
but is actually injurious to the body, and to receive a fresh 
supply of oxygen, which has been carried into the lungs in 
breathing. 

The blood is the great medium of exchange between all 
parts of the body. It is, at the same time, the nourisher 
and the scavenger of all the tissues. After the food has 
been liquefied and converted into new substances in the 
digestive system it is poured into the blood. From the 
blood all the tissues draw material to renew their own 
worn-out parts and other material which they store up 




Fig. 10.— The diaphragm (after Kitchen). 

as latent force, which, when it unites with the oxygen of 
the blood, becomes active force, such as heat and motion. 

The blood holds in suspension a vast number of minute 
cells or corpuscles ; the red corpuscles give its color to the 
blood, and are the oxygen carriers, while the white are the 
phagocytes or the protective agents of the body against 
disease. 

The blood constitutes about one-thirteenth of the body 
weight. Of this, one-fourth is distributed to the heart, 
lungs, and great blood-vessels, one-fourth to the liver, one- 
fourth to the skeletal muscles, and the remainder to other 
organs. • 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 143 

In order that the blood may be a satisfactory medium 
of exchange between all the tissues of the body two things 
are necessary — first, there must be through all parts of 
the body a flow of blood of a certain rapidity and general 
constancy; and, second, this flow must be susceptible 
of general and local modifications. 

The lungs are the essential organs of respiration or 
ventilators of the body. They are two in number, separ- 
ated from each other by the heart, are placed in a semi- 
distended state in the air-tight thorax, which we have 
seen they, together with the heart and great blood- 
vessels, completely fill. The lungs ultimately consist of 
air-cells, surrounded by dense plexuses of capillaries and 
nerves. The air-cells communicate with the exterior 
through the bronchial tubes, trachea, larynx, throat, and 
nose. 

The larynx is the organ of voice. It is situated be- 
tween the trachea and the base of the tongue, at the upper 
and back part of the neck, where it forms a considerable 
projection in the middle line, called Adam's apple. 

The trachea is a cylindric tube, which extends from the 
larynx downward about 4 \ inches, when it divides into the 
right and left bronchial tubes. The bronchial tubes, on 
entering the lungs, divide and subdivide, until finally they 
terminate in a lobule which is composed of air-cells and 
intercellular passages. 

In inspiration the cavity of the thorax is enlarged by 
an active contraction of the muscles, in consequence of 
which the pressure of air within the lungs becomes less 
than that of the air outside of the body, and this differ- 
ence of pressure causes a rush of air through the trachea 
into the lungs, until an equilibrium of pressure is estab- 
lished between the outside air and that within the lungs. 
This constitutes inspiration. Upon the relaxation of the 
respiratory muscles, the elasticity of the chest-walls and 
lungs, aided perhaps, to some extent, by the contraction 
of certain muscles, causes the chest to return to its original 
size. In consequence of this, the pressure within the 



144 PERSONAL HYGIENE FOR WOMEN 

lungs now becomes greater than that outside, and the air 
rushes out of the trachea, until the equilibrium is once 
more established — expiration. 

During quiet respiration all parts of the lungs are not 
equally expanded; it is chiefly the apices of the lungs, 
reaching up into the region of the neck, and the central 
parts of the lungs, which undergo the least change of 
volume. This lack of a thorough distention and aeration 
of every part of the lungs is a cause of weakness of the 
lungs as well as of the entire body, for it is precisely 
those parts of the lungs which are the least active that are 
most prone to become the seat of tuberculosis. 

In forced inspiration the cavity of the thorax is in- 
creased from 2 to 3 inches, partly by the elevation of the 
ribs and partly by the descent of the diaphragm, due to 
the contraction of its muscular fibers. In contracting, 
the diaphragm presses upon the abdominal viscera, push- 
ing them downward about 3 inches, so that a projection 
of the flaccid abdominal walls occurs. The movements of 
the diaphragm are less extensive in women than in men, 
which is believed to be due to the corsets and general 
manner of dress. A perfectly free mobility is necessary 
for change in the size of the chest and lungs, in which the 
respiratory movements take place from sixteen to twenty 
times a minute. 

The amount of air entering and leaving the lungs varies 
greatly in ordinary and forced respiration, being often 
three times as much in the latter. The volume of air is 
determined by the spirometer. Mr. Hutchinson, who 
invented the spirometer, has defined the vital ca- 
pacity of the lungs as that amount of air which can be 
expelled by the most forcible expiration, and so the meas- 
ure of the individual's respiratory power. The vital 
capacity varies according to a number of conditions, as 
age, sex, weight, but, most important of all, is the height. 
It has been found that between five and six feet the vital 
capacity increases eight cubic inches for each inch in 
height. 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 145 

The vital importance of the role which oxygen plays 
in the health and life of the individual may be better 
understood from the facts that about 10,000 liters of air 
are breathed daily, which makes the amount of food and 
drink consumed daily seem almost infinitesimal, and, 
important as the quality of the food is, the quality of the 
air is much more so, and, finally, that one can live for some 
days without either food or drink, but dies in a few min- 
utes if the supply of air is cut off. 

Secretion of the Lungs. — Like the lips and mouth, the 
lungs are invested on their free inner surface by a delicate 
mucous membrane, which constantly secretes a clear 
viscous fluid, the mucus. The lungs, therefore, like the 
nose, are always moist, and just as the nose is cleared by 
blowing it, so the lungs are cleared by hawking or cough- 
ing. A sense of discomfort or a feeling of irritation of the 
windpipe induces a deep inspiration, followed by an 
explosive expiration, which quickly brings up the mucus, 
so that it can be expectorated. The only difference be- 
tween the mucus of the lungs and that of other organs is 
that the former is mixed with air and has, therefore, a 
frothy appearance. 

The secretion of the lungs naturally flows down and 
accumulates, until it is voluntarily brought up and ex- 
pelled. Any one with a cold on the chest, or who is sub- 
ject to catarrh, will notice that, on moving about in the 
morning in making the toilet, especially on raising the 
arms to dress the hair, expectoration is greatly facili- 
tated, and that this is followed by a feeling of clearing 
out of the throat and lungs. 

Because .of the great aid given to the lungs in clearing 
them of mucus, moderate exercise in the open air is a 
much better treatment of an ordinary cold than a pro- 
longed stay in bed. And for the same reason, in the treat- 
ment of lung troubles, so soon as the temperature of the 
patient is down to normal, and her strength makes it safe 
to allow her to move about, the recovery of the patient 
is hastened by getting up and moving about the house. 
10 



146 PERSONAL HYGIENE FOR WOMEN 

Hygiene of the Lungs and Its Relation to the 
General Health. — Two conditions are essential for the 
preservation of the health and prevention of diseases of 
the lungs — good chest and lung development, and a con- 
tinuous supply of fresh air for the proper ventilation of 
the lungs. 

Fully one-third of the whole volume of blood is 
always circulating in the lungs, and each corpuscle passes 
through them 8000 times in the twenty-four hours. In 
other words, the lungs are the vitualizing stations of the 
corpuscles which unceasingly go hurrying by. If these 
carbonic-acid-laden corpuscles arrive in the lungs, and do 
not find the requisite amount of oxygen awaiting them, 
they return to the tissues, carrying part of their carbonic 
acid back to them instead of a fresh supply of oxygen, 
and so the tissues are weakened instead of being nourished, 
while the corpuscles themselves suffer from lack of proper 
nourishment and deteriorate in form and color. Imper- 
fect ventilation of the lungs is the most frequent cause of 
anemia or thinness of the blood. 

It must not be overlooked that the air may be fresh and 
pure, and yet not able to penetrate all parts of the lungs 
because of superficial and improper breathing. 

Relation of Respiration to Body Heat. — The heat 
of the body is generated by the oxidation of the tissues. 
The chilliness experienced by persons engaged in seden- 
tary occupations is by no means always caused by the 
low temperature of the room, as will be proved by the 
thermometer, but by the close air of the room and super- 
ficial respiration, which causes internal overheating with 
imperfect combustion. The correctness of this state- 
ment may be proved if the woman will throw the win- 
dows wide open and take deep breathing exercises for five 
minutes. She will then go back to her work thoroughly 
comfortable. In other words, she has breathed herself 
warm. 

The Respiratory Function of the Abdominal Mus- 
cles. — Woll-developed abdominal muscles play an im- 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 147 

portant part in expiration, hence, in emptying the lungs 
of their impurities. Under normal conditions the pres- 
sure in the abdominal cavity is greater than that of the 
atmosphere; hence in the elastic recoil following inspira- 
tion, the abdominal viscera constitute a buffer, so to 
speak, and drive the diaphragm upward. 

The chief causes of flabby abdominal muscles, with its 
consequent low intra-abdominal pressure, are a sedentary 
life, the wearing of corsets which prevent the free play of 
the abdominal muscles, and the overdistention of the 
abdominal walls by repeated pregnancies and by the 
accumulations of fat. 

As a result of lax abdominal walls, there is very fre- 
quently an enteroptosis or a falling of the abdominal con- 
tents far below their normal position; this includes the 
liver, spleen, pancreas, the intestines and stomach, and 
is the most frequent cause of floating kidney. 

Further, the accelerating influence of the diaphrag- 
matic movements on the circulation is seriously interfered 
with. 

The Importance of Good Chest Development. — 
The least chest development of the adult woman — that 
is, the underarm girth around the chest — consistent with 
good health is 28 inches, and this girth must be enlarged 
3 inches on forced inspiration. In ordinary respiration 
the waist expansion should be from J to 1 inch, while dur- 
ing muscular activity it should be from 1 J to 3 or 4 inches. 

In women the movements of the upper part of the chest 
are very conspicuous, the breast rising and falling with 
every respiration; whereas, in children and in men the 
movements are almost wholly confined to the lower part 
of the chest, and are called diaphragmatic, in contradis- 
tinction to those seen in women, which are called thoracic. 
It is now the opinion of many observers in this country 
and in Europe that the habit of thoracic breathing in 
women has been brought about by constricting the waist 
and the lower ribs. Observations made among the In- 
dians and Chinese women show that the abdominal is 



148 PERSONAL HYGIENE FOR WOMEN 

there the type of breathing, and civilized women who 
wore no corset had relatively good abdominal breathing. 
Further, that a thoracic type of breathing can be pro- 
duced in man by putting him in a corset. 

Vital capacity is, as we have seen, the term employed 
to denote the amount of air that can be expired after the 
fullest possible inspiration. The amount for persons 
5 feet in height has been estimated as 174 cubic inches, 
with an increase of 8 cubic inches for every inch in height 
above this. The relation between height and vital capac- 
ity is rather remarkable, since height is chiefly determined 
by the length of the legs, and not by the size of the trunk 
and thorax. This is due to the fact that mobility of the 
chest increases with stature. 

The capacity of the chest is determined by the spirom- 
eter. A person who can only blow, say from 180 to 
250 cubic inches, has a good pair of lungs, while, on the 
other hand, an ability to blow only 100, even where per- 
cussion and auscultation had revealed nothing, is sus- 
picious. 

One test by the spirometer is not sufficient to judge of 
the condition of the lungs, since the woman may be ner- 
vous or may not understand how to breathe into it, so 
that a number of tests should be made on different days, 
which may give a much better result, though no change 
has occurred in the lungs. 

Proper relation between the height, weight, and chest 
measurement : 



Height. 


Average weight. 


Average chest measurement. 


Feet. Inches, 


Pounds. 


Inches. 


5 


120 


29.80 


5 1 


122 


30.60 


5 2 


125 


, 35.00 


5 3 


128 


35.75 


5 4 


131 


36.25 


5 5 


135 


37.00 


5 6 


139 


37.50 


5 7 


143 


38.00 


5 8 


147 


38.50 


5 9 


151 


39.00 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 149 

The Chemical Properties of Air. — It is of more vital 
importance that the air which we breathe should be pure 
than the food which we eat should be, although the latter 
is universally conceded to be a matter of prime importance. 
The reason is that the poisons in the air, inspired by the 
lungs, pass directly into the blood, whereas, taken into 
the stomach, the action is much slower, and there is at 
least the possibility of their passing through the digestive 
tract unassimilated. 

The olfactory nerves are the normal guides as to the 
purity of the air, and, if they have not been dulled by 
long usage in breathing impure air, they are extremely 
sensitive to impurities in the atmosphere. 

Country Air. — In the open air there is a constant, even 
though insensible, movement of the currents of air; 
the result is a constant renewal or ventilation of the air. 
There is, in addition, the evaporation from brooks, rivers, 
lakes, the dew and rain, which aid in cleansing the air 
from dust ; the peculiar freshness of the air in the country 
after a heavy fall of rain is familiar to all. 

The " bouquet " of the air, most noticeable and delightful 
in the early morning, especially in the spring of the year, 
is due to the fragrance given off from the flowers, plants, 
and trees, and imparts a feeling of exhilaration and a 
sense of the joy of living. 

Sunshine increases the respiratory movements. 

Wind clears the air of impurities, and is only harmful 
when it carries dust with it, or when it is so strong that it 
impedes the respiration or bodily movements. Very 
weak persons get out of breath easily when battling against 
the wind. 

Town Air.— Even the outdoor air of towns has its full 
quota of oxygen,— 21 per cent.,— and so is healthier than 
indoor air. The carbonic acid in the air varies from 0.2 
to 0.6 per cent. Among the impurities of the air are 
smoke, fog, and dust. 

Dust and Its Relation to Disease. — Dust, consisting 
of particles of all kinds of organic and inorganic matter, 



150 PERSONAL HYGIENE FOR WOMEN 

is a nuisance of indoor as well as outdoor life. That the 
dust in cities is the intolerable nuisance and menace to 
public health that it is, is due to the filthy condition of 
the streets. 

The specific cause of tuberculosis is the tubercle bacil- 
lus. Considering the prevalence of the custom of spitting 
on the pavements, streets, floors of public conveyances, 
and public halls, that the dust from the streets is carried 
into the houses on the shoes and the trailing skirts of 
women, it is self-evident that anything which stirs up the 
dust, as sweeping, stamping on the floor with the feet, 
dancing, and on the streets strong currents of air and high 
winds are a most serious menace to the health and lives 
of the community. 

In addition to the fact that dust is the great carrier of 
the tubercle bacillus, the particles of dust cause a direct 
irritation of the mucous membranes lining the nose, throat, 
larynx, and bronchial tubes. 

That dust is an important factor in the causation of 
colds may be inferred from the facts that they are more 
common in the city than in the country, and that in the 
city they are more frequent in the spring and fall, when 
the streets are not watered. 

The R61e Played by Bacteria. — Bacteria are distrib- 
uted nearly everywhere and in larger quantities than is 
generally believed. The air in open spaces in cities con- 
tains from 100 to 1000 bacteria per cubic meter, while the 
air of an inhabited room contains from 6000 to 10,000. 

It can now be definitely stated that microorganisms 
are the immediate or exciting cause of bronchitis observed 
in diphtheria, in influenza, measles, whooping-cough, 
pneumonia, etc. These microorganisms are conveyed 
both directly from the sick to the well, and from the inhala- 
tions of the germs floating in the atmosphere. Whenever 
dust is raised, we breathe in a great number of micro- 
organisms. 

In influenza the bacilli are found in the secretions of the 
nose, throat, and in the expectorations from the lungs. 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 151 

The bacilli are not only the cause of the acute infections, 
but also of chronic bronchitis. 

The bacterial flora usually present in the throat and the 
respiratory passages is rich and varied. So long as the 
mucous membrane lining these passages remains in a 
healthy condition, an unfavorable condition is offered for 
their growth and development and these microorganisms 
are harmless. But just so soon as the general vitality 
is lowered, or there is an impairment of the normal condi- 
tion of the epithelium lining the respiratory tract, a cul- 
ture-medium is provided in which these germs flourish 
and grow. Anything which will cause an irritation or 
congestion of the mucous membrane of the throat and 
bronchial tubes furnishes the necessary conditions for the 
infection to take place. The germs themselves excite an 
acute inflammation, and the inflammation extends from 
the head or throat to the bronchial tubes, through the 
spread of the infective agent along the respiratory tract. 

Ventilation. — Very few people in cities spend more 
than one hour a day in the open air, which means that they 
are housed up for the other twenty-three hours, so that 
no pains should be spared to bring up the quality of the 
indoor air to approximate as nearly as possible that of 
the outdoor air. The air of houses contains many more 
microbes than that of the street. 

For dwelling-houses 3000 cubic feet of fresh air is needed 
every hour. It is said that in the country the only bad 
air is in farmers' houses, whence it has no chance to escape. 

Direct sunlight kills the tubercle bacillus in thin layers 
of sputum in five or six hours, and diffused sunlight in 
several days, and proper ventilation greatly facilitates 
this bactericidal action. A large cubic space is of little 
avail if the ventilation is inadequate. The windows 
should be at least one-seventh of the floor space. 

The air of the house must be fresh, pure, and cool, to 
allow proper ventilation of the lungs and skin. Colds 
are prevalent in winter, because that is the season when 
people are housed up and breathe impure air. 



152 PERSONAL HYGIENE FOR WOMEN 

The commonest causes of impurities of the air in houses 
are the expired air and the transudation of the skin; the 
production of the combustion of lights or unconsumed 
gas may come from the burner when lit, if the pressure is 
very strong, or the rubber fittings may retain the gas; 
tobacco smoke; the effluvia of simple uncleanliness of 
rooms and persons; and the products of the fluid or solid 
excreta retained in the room. In addition, there may be 
special conditions which allow the impure air to flow into 
the room, as from the basement or cellar of a house, from 
imperfectly trapped soil and waste-pipes, or from other 
impurities outside of the house. 

In respiration the air is vitiated by a decrease in the 
amount of oxygen and an increase in the amount of car- 
bonic acid; the expired air contains about 4 or 5 per cent, 
less oxygen and about that amount more of carbonic acid 
than the inspired air. It has been estimated that an 
individual takes into her lungs about 500 cubic inches of 
air per minute and exhales the same amount of vitiated 
air. The expired air is of a higher temperature, and is 
loaded with aqueous vapor. The organic substances 
present in expired air are in part the causes of the odor of 
the breath; it is probable that many of them are of a poi- 
sonous nature. The air is still further vitiated by the 
products of decomposition of persons having decayed 
teeth, nasal catarrh, and disorders of the digestive systems, 
as well as by personal emanations. 

When the sensibilities of the sense of smell become 
dulled, they give no warning of the sense of danger, and 
the individual may not feel conscious of the harm, al- 
though the nervous centers may be greatly depressed, 
and, because discomfort has not been experienced in a 
vitiated atmosphere, it does not follow that harm has 
not been done. The effects are slowly and imperceptibly 
cumulative, but are on this account none the less injur- 
ious, and are now recognized as being among the most 
potent and wide-spread of all the predisposing causes of 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 153 

The physiologic effects of breathing vitiated air are that, 
owing to the impurities of the air, the respirations become 
quicker and shallower, the heart's action more rapid and 
feeble; there is a more or less irritation of the mucous 
membranes lining the nose, throat, and larynx. In 
extreme cases, where many people are crowded together 
and the ventilation is totally inadequate, the air often 
becomes so impure as to cause headache, lassitude, nausea, 
and fainting. 

The long-continued action of such impurities on the 
olfactory nerves may ultimately induce, through the cen- 
tral nervous system, alterations in the respiration, circula- 
tion, and nutrition. When moderately vitiated air is 
breathed more or less continuously, the individual becomes 
pale and loses her appetite ; after a time there is a decline 
in the muscular strength and animal spirits. The aera- 
tion and nutrition of the blood is interfered with, and the 
general tone of the system falls below par. 

It has further been maintained that metabolism is 
hindered by much-breathed atmosphere. In addition to 
the ordinary symptoms of discomfort, the long occupancy 
of so-called stuffy rooms so lowers the resistance as to be 
conducive to the contraction of colds and even to more 
serious infections. 

People in this lowered condition of health, which is 
very common among those who spend the greater part of 
the day indoors, in offices, houses, schools, factories, and 
workrooms, offer much less resistance to attacks of acute 
diseases than do people who lead an outdoor life. 

In considering the ventilation of a house, the purity of 
the air, the temperature, and the dryness of the air must 
all be considered. 

The test now generally accepted as the standard of 
purity of the air is not the chemical one of the estimation 
of the amount of carbonic acid contained in the air of a 
closed space, but that, on entering a room or closed space 
from the outside fresh air, no sense of impurity or close- 
ness should be noticable. 



154 PERSONAL HYGIENE FOR WOMEN 

The so-called natural ventilation of houses, which 
takes place through the porosity of the walls, the cracks 
around the doors and windows, is generally too inconsider- 
able to be taken into account. 

Where houses are heated by furnaces, a certain amount 
of ventilation is furnished by this means, but the air is 
by no means so pure as the air of a house heated by hot air 
or steam pipes. In the latter case, the greatest drawback 
is the dryness of the air. 

As the air contained in an inhabited room cannot be 
kept as pure as the outside air, the object of ventilation is, 
by the admission of the pure external air, so to minimize 
the impurities that the air respired may not be detrimental 
to health. 

The most effective means for the ventilation of houses 
and apartments is the throwing wide open all doors and 
windows; the windows must be opened at both top and 
bottom, as the hot impure air rises and the cold air falls 
to the floor. The length of time which the house should 
be left open will depend on the outside temperature and 
the velocity of the winds. This ventilation of the entire 
house should be carried out three times a day — in the 
early morning, at noon, and again in the evening. 

In addition to this, provision should be made for a con- 
stant access of fresh air to the room. A simple and 
rather primitive method is by raising the lower sash by 
a strip of wood several inches in height and the exact 
width of the window. The air will then enter the space 
between the upper and lower sashes. Some such or 
any better method of ventilation should be in continuous 
use, day and night, when the room is occupied. So soon 
as the weather is sufficiently mild, some of the windows 
should be left open all the time. 

When the air of a room is fresh and pure, the human 
system is furnished with all the oxygen it can consume, 
and heat is thus introduced into the body, so that a 
lower external temperature is necessary for comfort. 
Hence, supplying a sufficient quantity of fresh air mini- 






THE RESPIRATORY AND CIRCULATORY SYSTEMS 155 

mizes the amount of coal consumed, besides increasing the 
vigor of the body. 

The temperature of the house will depend on the occupa- 
tion, age, and health of the inhabitants. With a sedentary 
occupation, a temperature of from 64° to 70° F. is the 
most suitable. The temperature of the bedroom at 
night should not be allowed to fall below 50° F. Every 
room in the house should be furnished with a thermometer. 

The Injurious Effects of Overheated Air. — A rise 
of temperature in the surrounding air diminishes the 
amount of oxygen consumed and the amount of carbon 
dioxid discharged; a fall of temperature has the opposite 
effect. In addition, this overheated air forms a hot 
jacket about the body, which prevents the radiation of 
heat necessary to keep the body in a healthy condition. 

For the same reason, when out-of-doors, furs should 
not be worn close up around the neck, and fur coats 
should only be worn in the extremely cold weather. 
Paper and rubber worn about the body act in the same 
way, by preventing the radiation of heat and moisture — 
practically steam jackets are formed; the skin is rendered 
very sensitive and susceptible of chilling on the slightest 
fall of temperature. 

The Proper Degree of Moisture of the Air of the 
House. — The air below the freezing-point is deprived 
of much of its moisture; brought into the house, and 
raised from 70° to 80° F., or drawn into the nostrils and 
raised to 98° F., it must take up its quota of moisture. 
This moisture must, therefore, be provided in the air of 
the house. In the case of houses heated by furnaces, 
some moisture is furnished by the water-pans of the 
furnace; but in the case of heating by hot air and steam 
pipes, there is less circulation of air, the air is very much 
drier, and generally of a very much higher temperature. 
A satisfactory method of furnishing these houses with 
the proper degree of moisture has not yet been invented. 

One is only comfortable in a dry air when it is of a low 
temperature. When the dry air becomes heated, there is 



156 PERSONAL HYGIENE FOR WOMEN 

more moisture given off by the mucous membranes, 
which causes a feeling of dryness and irritation in the 
nose, throat, and larynx; there may also be a sensation 
of uneasiness of the chest, and, at the same time, the 
individual feels chilly. 

Persons constantly breathing abnormally dry air lower 
the resisting power of the respiratory mucous membranes 
and become very susceptible of taking cold. 

Since the degree of moisture of the air of a house is 
equally important as its temperature, every room should 
be furnished with a hygrometer, which should register 
from 65 to 70 per cent, of moisture. 

The Ventilation of Bed-rooms. — The importance 
of the proper ventilation of the sleeping-room will be 
seen from the fact that two-thirds of the oxygen absorbed 
in the twenty-four hours is absorbed between 6 o'clock 
in the evening and 6 o'clock in the morning; and on 
the state of the air of the bed-room will depend greatly 
the vitality of the individual. During sleep inspiration 
occupies ten-twelfths of the respiratory period, while at 
other times it occupies only five-twelfths of that period. 
In a closed room the oxygen would eventually be con- 
sumed, the air become filled with impurities, and the body 
languish for want of oxygen and incapacity to throw off 
its impurities. 

The air of the room should be perfectly fresh on retiring; 
where it has been used as a sitting-room, it should be 
thrown wide open and thoroughly ventilated just before 
going to bed. The temperature of the room should not 
be above 65° F. In the bed-room at night all the air 
coming into the room should come from the same side 
of the room, and the doors opposite should be closed. 
If the room is small, and the window is at the head or 
foot of the bed, some provision must be made to screen the 
bed, and to allow the air to enter the room without 
falling directly on the sleeper. 

In the intense heat of summer, especially if the air is 
saturated with moisture, one sleeps much more com- 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 157 

fortably on the side, with the face almost at the edge of 
the bed; in this way the formation of a stagnant pool 
of exhaled air about the face is prevented, which would 
otherwise be rebreathed, and greatly increase the feeling 
of discomfort and malaise. 

On retiring at night the clothes worn during the day 
should be spread out over chairs to become thoroughly 
ventilated, instead of being hung up in a closed press or 
closet. From a sanitary point of view, it is essential 
that every article of clothing worn during the day should 
be removed at night. Both clothes and body need venti- 
lation. 

In the morning the clothes should all be taken off the 
bed, and they, as well as the night-clothes, should be 
spread out to be aired during the ventilation of the room. 
The windows are thrown wide open when one goes to 
breakfast. 

The Care of the Nose, Throat, and Ears. — It will be 
most profitable to consider the care of the nose, throat, 
and ears together, since the mucous membrane lining 
these cavities is continuous, and so there is always great 
danger of an inflammation of one extending to the others. 

It has been calculated that about one-third of our adult 
population are notably deaf in one or both ears. In the 
majority of cases deafness is the result of colds and 
throat troubles, and much can be done to prevent its 
occurrence. 

The nose communicates through the nasal fossae with 
the nasopharynx, and the mucous membrane lining the 
nose is continuous with that lining the throat. 

The nose performs four important functions — it serves 
as a passageway for the air in breathing, and it warms, 
moistens, and filters the inspired air; it is the organ of 
smell; it aids in phonation; and it affords ventilation 
to the ears and accessory sinuses. But by far its most 
important function is the role which the nose plays in 
respiration. To supply the large amount of water neces- 
sary to moisten the inspired air, it has been calculated 



158 PERSONAL HYGIENE FOR WOMEN 

that about one pint of water must be secreted by the 
nose daily; part of this amount of moisture is furnished 
by the tears. Mouth-breathing always causes dryness 
of the throat. 

The nitration of the air is accomplished first through 
the action of the hairs at the external margin of the nose, 
which hinder the entrance of large particles, and, second, 
by the adherence of small particles to the moist surface 
of the intricate passages of the nose and nasopharynx. 
The microbes are expelled with the dust; in addition to 
this, the nose probably has the power of destroying any 
bacteria through the action of its germicidal mucus. 

Obstruction of the Nasal Passages. — In adults the com- 
monest modes of obstruction are the bending of the nasal 
septum to one side, or by a thickening of the septum 
by which one nostril may be completely closed up. The 
occlusion may also be due to the swelling of the mucous 
membrane or the presence of polypi. 

In children the most common form of obstruction of 
the nose is by the adenoids and the enlargement of the 
tonsils; this enlargement may be so great as to prevent 
nasal breathing and interfere with the normal ventilation 
of the ears. 

The Throat or Pharynx. — The throat or pharynx is the 
upper and funnel-like portion of the alimentary canal, 
which is seen at the back part of the mouth. It extends 
up back of the nose. The cavity of the throat is some- 
what separated from that of the mouth by the soft palate. 
This is a membranous curtain, which is attached to the 
posterior part of the hard palate. The pendulous part 
of the soft palate is known as the uvula. The uvula 
sometimes becomes so greatly relaxed that it rests on the 
base of the tongue, which causes a constant irritation 
and slight cough, a condition which is easily relieved by 
a few astringeDt applications. 

On looking into a mirror there will be seen, on either 
side of the throat, two arches, formed by folds of mucous 
membrane; these are known as the pillars of the throat. 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 159 

Between these pillars, on either side, is an almond-shaped 
body called the tonsil. In health the tonsil should not 
protrude beyond the anterior pillar. 

Causes of Diseases of the Nose and Throat. — Exposure 
to wet and cold, when insufficiently clad, or, even worse, 
sitting still with damp skirts or shoes on. A still more 
potent factor than exposure to cold is the relative degree 
of humidity of the atmosphere; great humidity is fre- 
quently accompanied by epidemics of influenza. Ex- 
posure to very high winds; sudden changes of tempera- 
ture; the very dry air and the overheating of houses; 
insufficient covering at night; the inhalation of irritating 
vapors and finely divided mechanical irritants. Also, 
gastro-intestinal affections and uric acid. 

Chronic enlargement of the tonsils predisposes to 
tonsillitis and to all the infective and contagious throat 
diseases. In addition, the breath is apt to be fetid, and 
swallowing the mucus, germs, and toxins has a deleterious 
effect on the stomach and general health. Mouth-breath- 
ing and anemia often follow, and there is an increased 
liability to inflammation of the eyes. 

The Importance of a Healthy Condition of the Throat 
and Nose. — The nose and throat are the portals of entrance 
to the bronchial tubes and lungs, and it depends on the 
condition of their mucous membranes whether the germs 
of disease will find lodgment here and be carried down 
into the bronchial tubes and lungs, or whether they will 
be expelled with the mucus. 

Any irritant which destroys the vitality of the epi- 
thelium covering the mucosa, or a local congestion which 
interferes with the nutrition, circulation, and secretions 
of the part, offers favorable conditions for the culture of 
bacteria normally present. Also, anything which will 
cause a lowering of the general health, and thereby 
lessen tissue resistance, acts as a predisposing cause to 
local inflammation, while the germs themselves excite 
inflammation by their active growth in loco. 

From these facts will also be seen the importance of 



160 PERSONAL HYGIENE FOR WOMEN 

having cut short, as rapidly as possible, any congestion or 
inflammatory troubles of the nose and throat. 

Prevention of Nasal Catarrh and Sore Throat — First in 
importance comes attention to the general health. Under 
this must be considered the clothing, food, ventilation, 
and exercise. 

The clothing should be light, yet sufficiently warm to 
be a protection against the cold and winds. Heavy shoes 
with thick soles are necessary to protect the feet, and it 
is not so much the matter of getting wet as it is of sitting 
down with damp clothing on. 

An atmosphere filled with dust in sweeping should not 
be tolerated in any well-kept house. 

Local Treatment for the Prevention and Cure of Mild 
Cases of Nasal Catarrh and Sore Throat. — The treatment 
is practically the same. The toilet of the nose and throat 
should be made at least as often, and at the same time, 
as that of the teeth; certainly, the first thing on getting 
up in the morning and again before dressing for dinner. 
In our seaboard cities and towns, at least, there is a very 
general predisposition to some degree of congestion of 
the mucous membrane of the nose and throat. This means 
an abnormal amount of mucus which collects in the parts 
during sleep. Again, on coming in from out-of-doors 
on a windy day a large amount of dust, which means 
microbes as well, has become lodged in the mucous mem- 
branes of the nose and throat. 

This toilet of the nose and throat is best carried out 
by means of a nasal spray. The spray apparatus consists 
of a bottle holding some two ounces, a hard-rubber 
spray piece, and a bulb with tubing to force the liquid 
through the spray piece. The tip of the spray should 
have the form of a cone; this should be introduced into 
each nostril, the bulb squeezed several times, until the 
amount of fluid is sufficient to be hawked out, and this 
process is facilitated by holding the mouth open during 
the spraying of the nostrils. After the nostrils have been 
thoroughly cleansed, the throat should be sprayed directly. 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 161 

The liquids used must be bland and unirritating, and 
only enough should be used at one time to cleanse the 
parts. There are on the market excellent alkaline and 
antiseptic tablets; one tablet should be dissolved in a 
spray-bottle not quite full of water. This solution keeps in 
perfect condition, and is always ready for use. 

A solution of boric acid, in the proportion of two tea- 
spoonfuls of boric acid to one pint of water, may also be 
used. 

If the nose and throat are inflamed, this so-called water 
spray should be followed by an oil spray, which will be 
found to be most soothing and healing. A separate 
apparatus for this will be necessary, as an oily solution 
would clog an ordinary water-spray, but the principle 
of the spray is the same, and it is used in the same way. 
The following is an excellent formula: Take of menthol 
and carbolic acid each two grains; of eucalyptol, six drops; 
and of albolene, two ounces. Mix well, and fill the spray- 
bottle one-third full; it is to be used in the full strength. 
Use only enough of this spray to moisten the nose and 
throat; by inhaling simultaneously with squeezing the 
bulb, the very fine spray is carried into the larynx, and 
so is very useful when there is an irritation of that organ, 
as shown by hoarseness. If there is only a slight irrita- 
tion of the parts, the use of the spray twice daily will be 
sufficient; the last time should be just before retiring. 
On windy days it will be a great protection to the mucous 
membrane of the throat to use it just before going out- 
of-doors, on the throat only. If the inflammation is severe, 
the spray may be used as often as every two hours. This 
prescription should be put up by a good druggist. 

Ear specialists condemn all nasal douches as dangerous, 
•on account of the possibility of the water being forced into 
the Eustachian tubes. 

General Treatment. — First of all, the system must be 

toned up by the systematic use of cold baths, adapted 

to each particular case, tonics, iron, and cod-liver oil. 

It is a grave mistake to allow these cases to become 

11 



162 PERSONAL HYGIENE FOR WOMEN 

chronic, as they may be the forerunners of influenza 
and even general tuberculosis. They need prompt and 
scientific treatment, which the physician alone is capable 
of giving. 

The Ear. — The ear is divided into three parts — the 
external ear, the middle ear or tympanum, and the internal 
ear or labyrinth. The internal ear is the essential part 
of the organ of hearing in which the auditory nerve ends. 
Its structure is very complicated. The external ear is 
separated from the middle ear by the tympanic mem- 
brane or drumhead. This is a thin, small, membranous 
sheet, which is stretched tautly across the junction of 
these two cavities, and vibrates inward and outward 
between them. The external ear collects and conducts 
the waves of sound to the tympanum. 

The middle ear, or tympanum, is an irregular cavity, 
situated within the bone. It is traversed by a chain of 
movable bones, which connect the drumhead with the 
internal ear, and serves to convey vibrations of sound to 
it. The middle ear, or drum cavity, is filled with air, 
and communicates with the pharynx by means of the 
Eustachian tube. The middle ear is lined throughout 
with mucous membrane, which is continuous with that of 
the throat and nose. 

The Eustachian tube is continuous with the middle 
ear, and extends downward and forward about an inch 
to connect it with the pharynx, where it opens by a 
trumpet-like expansion, just above the soft palate, at the 
junction of the throat and nose. It serves to carry off the 
excess of fluid from the middle ear and to preserve the 
equilibrium of the pressure between the gaseous contents 
of this cavity and the atmosphere. The walls of the 
Eustachian tube are in close contact, but they are 
normally opened during every act of swallowing, yawning, 
etc., when the air finds its way into the middle ear. A 
stoppage of the nose reverses the process, and when the 
tubes are not likewise stopped up, every swallowing 
motion draws air out of the tubes. If the openings of the 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 163 

tubes become closed, deafness, dizziness, and subjective 
noises will result. 

The middle ear is the seat of about two-thirds of all 
aural troubles, and, since much of this could be prevented, 
this becomes a matter of great practical importance. 

Causes of Impairment of Hearing. — The majority of the 
affections of the middle ear originate from extensions of 
catarrhal inflammations, from the nose and throat, through 
the Eustachian tubes. In children adenoids are the most 
frequent cause of deafness. The so-called hereditary 
deafness is probably due to an inherited configuration 
of the septum of the nose, a bending of the septum to one 
side, or a tendency to catarrhal affections of its mucous 
membranes. 

Every cold in the head tends to mechanically involve 
the ears, and, while recovery may seem complete, there 
is likely to be some unrelieved trouble which insidiously 
but steadily increases — first one ear, and then the other, 
shows signs of defective hearing. If only one ear is in- 
volved, the condition may progress seriously before the 
patient is aware of the trouble. 

Preventive Measures Against Deafness. — From what has 
been said, it naturally follows that the preventive measures 
must be chiefly those already given against taking cold. 
If one does take cold, instead of leaving it to run its 
course, as is too often done, proper therapeutic measures 
should be at once adopted to bring as speedy a cure as 
possible. 

Impacted Ear-wax and its Removal. — A healthy ear 
should never show more than enough wax to render the 
hairs within soft, and the individual should be uncon- 
scious of the wax coming away. Wax does not collect 
in a healthy ear. When it does occur, there is a stopped- 
up feeling in the ears, due to the occlusion of the meatus 
by wax. 

The only procedure that is safe to follow in order to 
remove the wax from the ear is to gently douche the ear 
with warm water, at a temperature from 105° to 110° F. 



164 PERSONAL HYGIENE FOR WOMEN 

If this does not suffice, a physician must be consulted, as 
all efforts to remove the wax after it has become impacted 
are dangerous and futile except in skilled hands. 

Earache. — The best thing for the relief of earache is 
the external application of heat by means of a hot-water 
bag. If this does not give relief, the ear may be douched 
with warm water. Earache can often be prevented, by 
those subject to it, by placing a very small piece of 
absorbent cotton in the ear before going out in very high 
winds or in automobiling. 

Impediments to Normal Respiration. — These are, for 
the most part, acquired through improper habits of posture, 
dress, lack of muscular and chest development. Other 
impediments to respiration are a deviation of the septum 
of the nose to one side, marked curvature of the spine, 
and deformities of the chest which may be the results of 
rickets. 

Curvature of the spine is frequently the result of mus- 
cular weakness, combined with faulty position at the desk. 

The clothing must be sufficiently loose to admit of the 
fullest possible chest expansion; the measurements for 
the clothing, and most especially for corsets, must be 
taken during full chest expansion. 

Heavy clothing suspended from the shoulders is also 
hurtful, because it renders impossible the expansion of 
the apices of the lungs. Obviously, all tight bands around 
the neck interfere with the respiratory movements. 

Bodily position plays a very important part in main- 
taining the symmetric development of the chest and 
in the proper ventilation of the lungs; and this is a matter 
of the greatest importance to students, clerks, and writers 
who spend a great part of every day at the desk. 

The faulty attitude, together with the weak muscles 
and the poor muscular development, are fruitful sources 
of spinal curvatures and flat chests; and free respiration 
is interfered with. Writing with a pen is most apt to be 
accompanied by a peculiarly cramped position of the 
body, rendering normal respiration impossible. 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 165 

The Correct Attitude at the Desk. — The chair should be 
of such a height that the woman may rest her feet firmly 
and easily on the floor or upon a foot-rest, the seat being 
deep enough from before backward to accommodate about 
three-fourths of the length of the thighs, while the back 
of the chair should be so curved as to support the spine 
easily in its natural curves, both at the waist and at the 
level of the shoulder-blades. 

The chair and desk should be sufficiently close together 
so that the student may sit erect to read from books, 
since leaning forward at the desk causes round shoulders, 
flat chest, and short-sightedness. When the desk and 
chair are properly arranged, two-thirds of the forearm 
can be rested upon the desk without raising the shoulders. 

In reading, the distance of the book from the eyes should 
be twelve inches, and the book-rest should be inclined, 
sloping downward toward the reader, at about an angle 
of 85 degrees. 

If the woman has any great amount of writing to do, 
she should learn to use a typewriter. In using this 
machine she not only writes very much more rapidly 
and easily, but the position of the body is much more 
erect than that assumed when using the pen, and it is 
not nearly so fatiguing to the muscles of the hands and 
arms. 

All closely confining sedentary occupations, as writing, 
sewing, etc., should be frequently interrupted to move 
about for a few minutes, rest the eyes, and take a few 
deep breathing exercises before an open window; this 
is necessary for the eyes as well as for the ventilation of 
the lungs. 

Ventilation of the Lungs and Breathing Exercises. 
—Forced respiration is essential to completely change 
the air in the lungs, to maintain the elasticity of the lung 
tissue, and to expand the chest in every direction. Only 
in this way can a thorough ventilation of the lungs take 
place; a full supply of oxygen is taken in, which stirs 
up, disinfects, and cools the stagnant residual air, and 



166 PERSONAL HYGIENE FOR WOMEN 

forced expiration expels the respiratory excretions. One 
of the frequent causes of foul breath is lack of ventila- 
tion of the lungs, so that the expired air becomes laden 
with impurities. 

In normal breathing the current of air which passes in 
and out of the lungs travels through the nose, not the 
mouth. The ingoing air, by exposure to the vascular 
mucous membrane of the narrow and winding nasal 
passages, is warmed and moistened, and at the same time 
the mouth is protected from the desiccating effects of the 
continual inroad of comparatively dry air. 

By means of respiratory exercises the mobility of the 
chest may be greatly augmented; there is an increased 
flexibility of the ribs and sternum, as well as loosening 
of the thoracic joints, which may have become stiff, and 
these exercises also lead to a development of the respiratory 
muscles. 

In this manner only can the frame work of the chest 
become thoroughly inflated from within, and thus all 
parts of the lungs, which run the risk of becoming in- 
capacitated from lack of use, be brought into play. 

It is highly important that this thorough ventila- 
tion of the lungs should take place at least three times 
a day — the first thing in the morning, while making the 
toilet, again about the middle of the day, and at night 
just before retiring. 

To obtain the greatest benefit from these exercises 
they must be taken without corsets, the clothing must be 
light and loose, and the body lightly clad. The air in 
the room must be fresh, and after they have been learned, 
they can, as a rule, be taken before an open window. In 
the morning they are best taken just after the cold bath, 
when, by removing the impurities and filling the lungs 
with fresh air, and at the same time starting up a good 
vigorous circulation, they cause one to begin the day 
with energy and zest. 

The respiratory movements are diminished during 
sleep, and at the same time there is a large accumulation 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 167 

of blood in the splanchnic veins, so that, particularly 
when there is any tendency to difficulty with the breathing 
at night, the trouble is greatly lessened by filling the lungs 
with pure air just before retiring. 

It is necessary, first of all, to learn the art of breathing, 
to be able to dissociate the clavicular, the costal, and the 
diaphragmatic. By clavicular breathing is meant the 
raising of the collar-bone and shoulders as high as possible 
by means of a slow but deep inspiration — this expands the 
apices of the lungs; costal breathing is the throwing out 
and expanding the chest to its utmost capacity, and so 
enlarging the chest in its transverse and anteroposterior 
diameters; diaphragmatic breathing is the depression of 
the diaphragm and the protrusion of the abdomen with- 
out raising the lower ribs. The last is the most readily 
learned in the supine position; the bed supports the weight 
of the body, so that the individual is able to concentrate 
her entire attention on fixing the bony thorax, depressing 
the diaphragm, and protruding the abdomen at every in- 
spiration and retracting it to the utmost with every ex- 
piration. This, of course, develops and gives tone to the 
abdominal muscles. 

When the woman has conquered these first principles 
of respiration, she is ready to put them into practice 
in the standing posture. They should be learned before 
a mirror, and after that taken before an open window. 
The hands should be placed on the hips; first elevating 
the collar-bones and the shoulders to the utmost, while 
still holding the breath, she expands the chest, always 
breathing in from above downward, and, lastly, the 
diaphragm is depressed. With the lungs thus expanded 
to their utmost capacity, the breath is held as long as 
possible, then the lungs are emptied by an abrupt and 
forced expiration. 

These exercises should be repeated at first ten times, 
gradually increasing to thirty times. It is well to take 
one or two ordinary respirations between the forced 
ones. 



168 PEKSONAL HYGIENE FOR WOMEN 

It will be found that, as these exercises proceed and 
the lungs are rilled with purer air, the breath can be held 
for a longer period of time, and that with practice the 
length of time that the breath can be held is greatly 
increased; it should be held for half a minute. Public 
speakers, singers, and divers are all skilful in this respect. 

When these simple breathing exercises have been 
mastered, breathing exercises can be combined with 
other exercises, which have as their aim the development 
of the muscles of the chest. 

Reading aloud, singing, talking, laughing, are all good 
exercises for developing the capacity of the lungs. 

The Cure of Chronic Bronchitis by Deep-breathing 
Exercises. — The upper part of the body must be nude 
and the exercises taken before a mirror, so that the 
woman can watch the movements of the chest and 
abdomen, see that all the hollows of the chest are filled 
out during forced inspiration, and that the muscles of 
the abdomen are properly retracted. For the average 
woman this last will be the most difficult; in beginning 
these exercises she will find that it will require all her 
concentrated energy and will power to cause a retraction 
of these disused muscles. 

Patients with chronic bronchitis do not have the 
ability to perform forced respiration properly. The 
respirations are too superficial, and the respiratory move- 
ments are not properly performed. 

As respiration is ordinarily performed, the partial 
expansion of the upper part of the chest is accompanied 
by a contraction of the abdominal muscles, whereby the 
diaphragm is forced upward, with the result that the 
lower part of the lungs remains very slightly expanded, 
whereby the circulation as well as the removal of mucus 
is imperfectly performed. This lack of forced respiration 
is a frequent cause of acute bronchitis running into a 
chronic form. 

In chronic bronchitis it is especially in the lower part 
of the lungs that stagnation of the secretions takes place, 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 169 

and they can only be dislodged from the mucous mem- 
brane by forced abdominal expiration and the ascent of 
the diaphragm. This causes a cough which expels the 
mucus, and forcible abdominal expiration and cough 
are the only means of drainage of the lower and deep- 
seated parts of the lungs. Further, in forced respiration 
the muscle tissue of the bronchial tubes contracts, which 
certainly does not take place in ordinary respiration, but, 
on the contrary, this tissue atrophies. 

Other beneficial results from forced respiration are 
increased oxygenation, improved nutrition, changes of a 
mechanical nature, ventilation, and disinfection of the 
lungs, massage of the lungs and pleura, and drainage. 

No other method of treatment is so successful in the 
cure of chronic bronchitis not dependent on disease 
of the nose and throat. In from two to six weeks of treat- 
ment, in which there is a profuse discharge of mucus, 
it will be found that the bronchial tubes have cleared up, 
provided that the patient is supplied with an abundant 
supply of fresh air day and night. Methodically practised, 
deep breathing is not only the surest cure, but also the 
safest stimulating expectorant. 

Relation of Colds and Influenza to Pneumonia and 
Tuberculosis and their Prevention. — We have already 
seen that bacilli are not only the cause of acute infec- 
tions, but also of chronic bronchitis, and that this was 
especially true of the bacillus of influenza and the pneu- 
mococcus of pneumonia. 

It is well known that influenza is an infectious disease, 
which rapidly spreads through the family and the com- 
munity, but it is not so well known that the so-called 
"common colds," ordinary sore throat, and tonsillitis 
are also highly contagious. The infection is carried from 
one person to another by direct contagion; the air is 
being constantly sprayed with the germs of disease in 
talking, laughing, sneezing, and coughing. In coughing 
and sneezing it is not sufficient to hold the hand before 
the mouth — a handkerchief must be used for this purpose. 



170 PERSONAL HYGIENE FOR WOMEN 

Colds are among the most frequent of the so-called 
minor ailments in this country. The causes are the over- 
heating of the houses, the great dryness of the air, badly 
ventilated houses and public assembly rooms, which 
render people very susceptible to the great variations in 
temperature. 

Prophylaxis, or the prevention of colds, combine all those 
measures which promote the general tone of the system, 
and may be said to embrace all the elements of personal 
hygiene. Good digestion and proper nourishment of 
the body with suitable food; the proper ventilation of 
houses, all public buildings and conveyances, for in these 
latter the public are brought into very close contact with 
their fellow-men. 

Local prophylaxis would consist in the toilet of the 
nose and throat — the removing of adenoids and enlarged 
tonsils. 

The individual must remember that she can reinfect 
herself; for this reason, an abundant supply of hand- 
kerchiefs must be used; they should be placed in a 
handkerchief bag and washed separately. Packs of cards 
should be thrown away before they become soiled. Sprays 
and atomizers must be individual property, and be kept 
thoroughly cleansed. 

With the exception of deep-seated chest colds, in the 
early stages a cold may often be nipped in the bud by a 
few hours of hard sudorific work in the open air. In half 
a day the nasal ducts and respiratory system will throw 
off irritating matter that would take much longer time 
if the patient remained indoors and relied on the action 
of drugs alone. 

Treatment. — Other methods of treatment are a hot 
tub-bath on retiring, an active but not too severe cathartic, 
as two grains of calomel, taken just before going to bed, 
and, if the individual is chilly, a hot lemonade should be 
taken at the same time. Both the cathartic and the 
free perspiration will aid in relieving the internal con- 
:ion and thus aid in its abortion. A cold sponge 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 171 

should be taken the following morning to tone up the 
system. Turkish baths are also useful in breaking up 
colds; again, the precaution must be taken to avoid chill- 
ing on leaving the bath. 

The following tablet is a very simple and very efficacious 
remedy for breaking up a cold in the early stages: Take 
of powdered camphor \ gr.; of the sulphate of quinin 
J gr. ; and of the nuidextract of belladonna root \ minim. 
This should be well mixed, and made up into one tablet 
or a capsule. One tablet is taken every half-hour, until 
four doses have been taken; after that one tablet every 
three hours, until the running of the nose has ceased, 
which generally occurs within twenty-four hours. If 
there is not marked improvement at the end of this time, 
or if there is any fever, a physician should be consulted 
at once. 

Quinin, when given alone to abort colds, must be given 
in sufficiently large doses to produce cinchonism, the 
subjective symptom of which is a slight deafness or 
ringing of the ears. The natural tendency of cold is to 
cause inflammation of the middle ear, and since the use 
of quinin in large doses causes a congestion, and so pre- 
disposes to inflammation of the middle ear, its use should 
be avoided. 

The great amount of illness and mortality from pneu- 
monia during and following epidemics of influenza is 
too familiar to the public to need more than mentioning. 
The patient is so rapidly and extremely prostrated by 
the attack of influenza as to be susceptible to the ready 
action of the pneumococcus, which, as we have seen, is 
ever present, and the extension of the inflammation 
from the fine bronchial tubes to the air-cells of the lungs 
rapidly takes place. In the exhausted condition of the 
patient she is not able to resist this invasion, the heart 
is already weakened, and death frequently rapidly ensues 
as the immediate result of heart failure. 

The Prevention of Tuberculosis. — The tubercle 
bacillus is practically ubiquitous, and the prevalence of 



172 PERSONAL HYGIENE FOR WOMEN 

tuberculosis is universal. Hence it is imperative to 
raise the resistance of the individual in every way pos- 
sible, as well as to limit the spread of the infection. This 
means the employment of all the resources of public and 
personal hygiene, public and private sanitation, and the 
education of the public in how the disease is disseminated, 
and how its spread may be prevented; also the teaching 
of the individual, her duty to the family and society, as 
well as to herself, in order not to spread the contagion. 

Tuberculosis attacks the crippled and poorly developed 
lung just as surely as it shuns the one which is fully ex- 
panded and in constant and active service. Numerous 
observations have established the existence of a constant 
ratio between tuberculosis of the lungs and deficient 
chest expansion. 

Diet. — The doctrine has been growing among the laity 
that the child's likes and dislikes should determine what 
food it should eat. Thus a finical taste is cultivated 
and a lack of proper nourishment follows, and it is this 
finical diet class of people which forms a large percentage 
of tuberculous invalids. It has long been recognized 
that a proper diet and the tolerance of it is of the utmost 
importance in the treatment of tuberculous patients, 
but from the foregoing it would appear that a proper 
diet throughout life is also of the utmost importance 
in the prevention of disease; a sufficiency, not only as to 
quantity, but also as regards variety. 

It is the patient who can eat everything who stands a 
good chance of getting well. So, too, it is the individual 
whose diet for years has been perverse, who could not 
eat meat, to whom eggs were distasteful, who could not 
stand milk, who was infected with the vegetarian fad, 
or the two-meal-a-day fad, who stands a fair chance of 
falling a victim to tuberculosis, through a lowered tone 
of the system, because it offers but a feeble resistance 
to a powerful and insidious enemy. And the mode of the 
preparation of the food is an equally important factor. 
It has been shown that the poor cooking among the lower 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 173 

classes is a powerful predisposing cause to intemperance 
and tuberculosis. 

Influenza is a frequent and important agent in bringing 
to light latent tuberculosis, and must be classed as an 
important exciting if not predisposing cause. Low, 
damp climates predispose to the infection by lowering 
the vitality. Tuberculosis is more prevalent in cities 
than in rural communities, due to the manner of housing 
and the character of the occupation. 

Summary of the Present Views of Infection. — The doctrine 
of inherited and acquired susceptibility still holds sway; 
next, that all infants are susceptible, and that suscepti- 
bility lessens with increase in age; that adults are com- 
paratively insusceptible when free from general and local 
lowered resistance and repeated and prolonged exposure. 

As to the source of infection, the consensus of opinion 
and ascertained facts point to the sputum as of over- 
whelming importance; cow's milk is an important factor; 
the food may be infected directly by coughing, or the 
dirt and dust from the floor and hands; the fingers and 
many other objects that find their way into the child's 
mouth are sources of danger. To adults, both dust and 
moist droplets are more often the source of infection than 
infected food. 

Expectoration. — Careless expectoration is the chief 
source of infection. Laws should be passed and enforced 
prohibiting the expectoration on pavements, stairways, 
in all public conveyances, and all public places. 

The danger of infection from tuberculous house servants 
has not been sufficiently appreciated. A chronic cough 
in the case of a servant should be at once investigated 
by the family physician. Servants should be taught 
the necessity for washing the hands before touching the 
food or cooking utensils. The condition of their rooms, 
clothing, bathing, and other personal habits should be 
closely investigated, and personal cleanliness should be 
demanded as a sine qua non for obtaining or keeping a 
situation. 



174 PERSONAL HYGIENE FOR WOMEN 

Since it is a well-known fact that tuberculosis can be 
acquired from the occupation of houses and rooms 
formerly occupied by tuberculosis patients, it has been 
suggested that a clean bill of health should be demanded 
of the owner of the house before renting it; that is, 
a certificate from the Board of Health, that no case of 
infection has existed in the house, or that it has been 
properly disinfected since that time. If such a move- 
ment became popular, landlords would be obliged to 
furnish these bills of health in self-defense. Since the 
Boards of Health demand the reporting of all cases of 
tuberculosis, this scheme is by no means impracticable or 
Utopian. 

The tubercle bacillus is not destroyed by any degree 
of cold, but both light and sunlight are distinctly injurious 
to these bacteria. The lowest fatal temperature to the 
tubercle bacillus is 131° F. of moist heat, acting for a 
period of six hours. The thermal death-point of tubercle 
bacilli in milk is of great practical importance, and many 
experiments have been made which have determined that 
a temperature of from 140° to 167° F., was sufficient if 
continued for one hour. If it is desired to pasteurize the 
milk, it should be placed in a closed bottle or stirred and 
heated for at least twenty minutes at a temperature of 
149° F. 

Disinfection. — The use of formaldehyd gas has practi- 
cally displaced the use of sulphur for the fumigation of 
rooms, as well as for the disinfection of furniture and 
clothing. For this purpose a moist vapor used in a sealed 
room is essential. 

At least 8 ounces of the commercial 40 per cent, formalin 
should be used for each 1000 cubic feet of air content. 
The most efficient method is that used by Biggs, of New 
York, which is as follows: For an ordinary room, 1000 
cubic feet, 1 pound of lime, 8 fluidounces of formalin, and 
from 2J to 3 fluidounces of commercial sulphuric acid 
are required. All openings but the door are sealed. The 
formalin is poured into an empty water-pitcher, 4 ounces 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 175 

of water are added, and then the sulphuric acid is poured 
slowly in. The lime is placed in a china or earthenware 
wash-basin on the floor upon newspapers; all water is 
removed from the room. All drawers and cupboards 
opened; the mattresses stood on end; and the mixture 
poured quickly upon the lime, when the door is sealed. 
The sulphuric acid may be packed in a tin bucket contain- 
ing the lime, and, with the formalin in a separate bottle, 
may be used by any person of ordinary intelligence. 
The room should remain closed from twelve to eighteen 
hours. It must not be lost sight of that after disinfection 
by means of formalin a thorough cleansing is imperative. 
A room which has been thoroughly cleaned and carbolized 
is safer than a room which has been disinfected with 
formalin and not properly cleaned. 

After death or removal the entire place should be 
renovated. Besides disinfection and scrubbing the 
painted woodwork with a solution of hot soda water, 
the walls should be repainted or repapered, and the wood- 
word repainted. 

Rugs, bedding, pillows, and clothing should be disin- 
fected by hanging up in the room while it is undergoing 
disinfection. Books and all articles of small value should 
be burned. All soiled linen should be boiled. 

The Kidneys and their Function. — The kidneys are 
the secretory organs of the urine; they are two in number, 
and are the largest tubular glands in the body. They 
are deeply seated in the lumbar region, lying one on each 
side of the vertebral column; the kidneys extend from 
the eleventh rib nearly to the crest of the pelvis. They 
are usually embedded in a considerable quantity of fat, 
which is the chief factor in holding them in position, 
aided to some extent by the large blood-vessels with 
which they are connected. The kidneys are oblong 
bodies and measure about 4 inches in length, 2J- inches 
in breadth, and over 1 inch in thickness. Their weight 
is about 4J ounces. 

As an excretory organ the kidney probably stands 



176 PERSONAL HYGIENE FOR WOMEN 

second to the alimentary canal; it surpasses in importance 
the skin, whose total excretion of water it equals. The 
abnormal substances appearing in the urine are often 
not the products of disease of the kidneys, but of some other 
organ or system. 

The kidneys excrete and put the finishing touches 
upon the urinary fluid; they act at the end of the meta- 
bolic course, both as active and as passive agents. While 
to some extent the kidneys are mechanical contrivances, 
mere filters, so to speak, they are to a far greater degree 
active, specific glands. The renal epithelium has the 
power of synthesis, and builds up complex substances 
that are not apparent as such in the blood or lymph, as 
well as the power of analysis or breaking down of sub- 
stances. These changes are due to the formation in 
the tubular cell of an enzyme, which we call histozyme. 
The kidney is the end link in the vascular chain, and the 
daily performance of healthy kidneys is no doubt a 
combination of the mechanical and the vital processes. 

The Secretion of the Urine. — In a perfectly normal being 
the problems of waste and repair are balanced to a nicety. 
As we know, the tissues of the body are bathed in lymph 
containing in solution the compounds that are necessary 
for their nourishment — proteids, carbohydrates, fats, 
salts, and gases. Waste follows in direct proportion to 
the activity of the tissues. The worn-out, effete material 
first finds its way into the lymph, and from it into the 
blood-stream, to be later eliminated from the economy, 
else deleterious results will follow their retention in the 
body. It is by the selective action of the cells of the 
various glands of the body that these useless substances 
are removed from the blood, and converted into such 
forms as can be readily excreted. In the main, the 
products to be removed are urea and the allied nitrogenous 
bodies — carbon dioxid, salts, and water. These organs 
are of vital importance, since nearly all of the waste- 
products containing nitrogen are eliminated in the urine. 

The most easily understood function of the kidneys 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 177 

is the excretion of the urinary water; this varies in amount 
with the rapidity of flow through the renal vessels and 
to some extent on the blood-pressure. 

The separation of the solid substances of the urine 
form the next function of the kidneys, and these substances 




Fig. 11. — Relation of kidneys to heart and great blood-vessels: A, 
Heart; B, B, kidneys; C, bladder (after Quain). 



fall into two groups — inherently useful materials, which 
are in excess or which have served their purpose, and 
substances which are inherently harmful. The latter class 
embrace many end-products of metabolism, which we are 
accustomed to consider as normal constituents of the urine. 



178 PERSONAL HYGIENE FOR WOMEN 

The analytic study of the urine is of great value to the 
physician and surgeon, because of the knowledge which 
it gives concerning the processes of metabolism occurring 
within the body. The nature and amounts of the various 
end-products of metabolism are carefully investigated as 
they occur in the urine, whether they be normal or patho- 
logic. 

The Urine. — The normal human urine recently passed is 
a clear liquid, of a straw color, with an average specific 
gravity of 1020, the specific gravity indicating the amount 
of solids contained in the urine. It is acid in reaction. 
The quantity for twenty-four hours is 50 ounces, or 
about 3 pints, depending on the amount of water ingested. 
During sleep the amount secreted is less than at other 
times. The amount of urine is decreased after profuse 
sweating, diarrhea, thirst, diminution in the blood-pressure, 
and after severe hemorrhage. When the body temper- 
ature is considerably higher than normal, the amount of 
urine is again diminished in quantity. 

Urea forms nearly one-half of the solids in normal urine 
and nearly one-half of the urea is nitrogen. It is the 
principal representative of the waste of the nitrogenous 
tissues. The chief source of urea is from the metabolism 
of the muscles ; the ingestion of a large amount of proteid 
food stimulates metabolism. The quantity of urea 
passed in the twenty-four hours is about 500 grains. 

The uric-acid constituent is very small, and in the 
human urine scarcely reaches 0.03 per cent, of the solids. 
Lack of exercise leads to an increased formation of uric 
acid by a lessening of the oxidation of the tissues. In 
gout the amount of uric acid excreted is abnormally small, 
because it accumulates in the blood and tissues. The 
brick-dust deposit sometimes seen in the urine is composed 
chiefly of the urate of sodium. The average daily amount 
of uric acid passed in the human urine is about 7 grains. 
The excretion of uric acid may be increased by drinking 
copious drafts of water. 

Toxicity of the Urine. — After the removal of both kid- 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 179 

neys the animal dies of uremia; that is, there is an accu- 
mulation of urinary products in the blood. The removal 
of one kidney is not necessarily fatal, and women have 
so lived very comfortably for many years. A human 
being excretes enough poisonous material by the kidneys 
in two days to cause death. 

The Urinary Excretory Apparatus. — After the urine 
has been secreted by the kidneys it must be carried away 
from the body, so that the economy may not suffer from 
the resorption of the contained toxic principles. The 
excretory apparatus comprises the ureters, the bladder, 
and the urethra. 

The ureters are two cylindric tubes of the diameter 
of a goose-quill and about 15 inches long. They make 
their exit from the inner border of the kidney, and pass 
downward and inward toward the median line, to empty 
into the base of the bladder by a slit-like orifice. 

The bladder is the reservoir for the urine. It is a 
musculomembranous sac, situated in the pelvis, and in 
the female it is in front of the uterus and above the vagina. 
It normally contains one pint. It should be emptied four 
times a day. If it is allowed to go longer than this, it 
becomes overdistended, and is apt to displace the uterus 
backward, and the bladder-walls themselves become 
weakened. 

The Physiology of the Female Generative Organs. — 
The internal and essential organs of generation are the 
uterus, ovaries, and the Fallopian tubes. These organs 
have to do with the process of ovulation, menstruation, 
and reproduction. 

The Ovaries. — These are two small bodies of an almond 
shape, and lie one on either side of the uterus. The bulk 
of the organ consists of connective tissue, in which lie 
embedded the Graafian follicles, or ovisacs, in which the 
ova are contained. 

During the child-bearing period, or from about the age 
of fifteen to forty-five years, the development of the 
Graafian follicles and the discharge of the ova are con- 



180 PERSONAL HYGIENE FOR WOMEN 

tinually taking place. The liberation of the ova usually 
takes place at definite times, which, in general, coincide 
with the menstrual epochs, one or more ova being set 
free at each period, but this is by no means invariable. 

The Uterus. — The virgin uterus is a small, hollow, 
muscular organ, somewhat pear shaped, whose cavity is 
about 1J inches deep. The uterus is situated in the 
middle of the pelvic cavity, between the bladder and the 
lower bowel. It is held in position by broad elastic 
bands, which go to different sides of the pelvis; it is also 
in part supported by the structures below and above it; 
but so loosely is the uterus held that it is easily pushed 
about, as, for instance, by a full bladder or a packed 
bowel, and persistently allowing the bladder to become 
overful, and failure to have a daily evacuation of the 
bowels, are prolific sources of displacements of the womb. 

Respiratory Movements of the Uterus. — When no constric- 
tions are placed about the waist, the uterus moves freely 
up and down with every respiration. So distinctly, and 
with such regularity, do these movements occur that an 
operator, by watching the movements of the uterus, 
can tell the effect that the anesthetic is having on the 
patient's breathing. These so-called respiratory move- 
ments play a very important role in the circulation of the 
uterus, and in the return of the venous blood to the heart. 

Anything which interferes with these movements, as 
the wearing of corsets or of tight bands about the waist, 
prevents the free return of the venous blood. The uterus 
becomes congested, and through the constant abnormal 
weight of the organ itself, as well as by the pressing down 
upon it from above of the superincumbent organs, the 
uterus is pushed down below its normal position, the 
ligaments whose duty it is to hold it up become relaxed, 
and the unhappy woman suffers all the agonies that are 
attendant on the "falling of the womb." For this reason 
the disorder is frequently met with in women who have 
never borne children as well as in those who have. 

The Functions of the Uterus. — The function of the 






THE RESPIRATORY AND CIRCULATORY SYSTEMS 181 

uterus is to provide a favorable place for the reception 
of the product of conception, where it may be protected 
and nourished during the period of its development. 
The purpose of menstruation is to keep the uterus in 
suitable condition for the reception of this product of 
conception at any time. It is now known that the 
menstrual flow is not the whole of menstruation, and that 
the changes going on in the uterus are almost as continuous 
as the process of digestion. 

Average Duration of the Menstrual Flow. — The average 
duration of the menstrual flow is five days, although 
the variations are considerable in healthy women. A 
flow lasting any place from two to six days is perfectly 
consistent with health, but a flow continuing less than 
two days or more than six days generally indicates a 
local or general disease. 

Character of the Menstrual Flow. — For the first few 
hours, or perhaps for the first day, the flow is usually 
slight in quantity and light in color; on the second and 
third day the flow reaches its height, and is profuse and 
dark in color, but it should never be clotted; after this 
it generally ceases. The amount of the flow varies from 
5 to 10 ounces. If less than 5 or 6, or more than 18 
napkins, are pretty well saturated through, the amount 
may be considered abnormal. 

Premonitory Symptoms of the Flow. — The premonitory 
symptoms of the monthly flow should not be so marked 
as to cause the individual any discomfort. The first 
indication of the return of the period should be the flow. 
There is generally a feeling of abdominal fulness, with 
some lassitude and sometimes slight headache. The 
temperature is lower and the pulse is slower than at other 
times. This lowered tone of the system is an additional 
reason for increased care against exposure in wet or cold 
weather. 

Hygiene of Menstruation. — During the menstrual 
period all cold baths must be strictly prohibited, whether 
tub-baths or cold sponges. The reason for this is that the 



182 PERSONAL HYGIENE FOR WOMEN 

application of cold to the surface causes a driving in of 
the blood from the exterior of the body to the internal 
organs, and, at the time of the menstrual periods, there 
is already a congested condition of the pelvic organs, 
and it must be remembered that congestion is the first 
stage of inflammation. 

Hot or warm sponge baths may be taken throughout 
the period, and the vulva should be bathed with warm 
water twice a day throughout the entire period of the 
flow, as this not only removes the clotted blood before 
it decomposes and becomes the source of irritation, but 
also removes other irritating matters, and prevents the 
nervousness that is caused by local irritation. 

Another question which is still sub judice is the necessity 
for and the frequency with which vaginal douches should 
be taken; all physicians are agreed that a vaginal douche, 
taken immediately after the menstrual period, is beneficial, 
as it removes all of the debris of the flow, which is some- 
times very irritating. 

Exercise. — A moderate amount of exercise should be 
taken every day; this is needed now quite as much as 
at any other time, and only good can result from it, 
and no harm comes of a woman going out in the rain or 
the cold weather. As has been shown, the menstrual 
process is going on for a large part of the time, and the flow 
is only the external appearance, but during the time of 
the flow the woman must be unusually careful not to 
get her feet wet or sit down with damp clothing on. 
Violent exercise of all kinds is to be prohibited at this 
time, as dancing, bicycling, gymnastics, and walks of 
over three miles. The reason for this is very obvious: 
the uterus has now reached the height of its turgescence, 
and is heavier than at any other time, hence the danger 
that displacements or a very profuse flow would be caused 
by any land of violent exercise. 

Treatment. — If the woman has been so unfortunate 
as to have been caught out in a heavy rain, so that her 
clothes have been wet through, or if in the cold weather 



THE RESPIRATORY AND CIRCULATORY SYSTEMS 183 

she should come into the house thoroughly chilled, the 
best thing to do is to take off her wet things as quickly 
as possible; be well rubbed down with hot rough towels; 
drink a cup of hot tea, and go to bed at once, with a hot- 
water bag placed over the abdomen or under the small 
of the back. She should remain in bed until the next 
morning, to the end that the circulation may regain its 
equilibrium as quickly as possible by the immediate 
relief of the pelvic congestion. 

If this exposure should have caused the sudden cessa- 
tion of the flow, a hot mustard foot-bath should be taken. 
One tablespoonful of ground mustard is used to the 
gallon of water, as hot as it can be borne; the pail should 
be made as nearly full as possible, without running over, 
and a blanket wrapped about the pail and woman, so as 
to cause a profuse perspiration; this should be kept up 
for ten minutes; as the water cools off, hot water may be 
added. 

Profuse menstruation, painful menstruation, and scanty, 
very slight, or irregular flow are all abnormal conditions 
that are due to some abnormal or pathologic causes, and 
a good gynecologist should be at once consulted, so that 
not only suffering may be prevented, but that serious 
consequences to the general health may be averted. 



CHAPTER VI 

THE NERVOUS SYSTEM AS THE BALANCE OF 
POWER IN THE BODY 

The Brain the Master Organ of the Body; the Functions of the 
Brain; Habit and Automatism; the Physiology of the Brain and 
Nervous System; the Hygiene of Work; the Toxins of Fatigue; 
Overwork; Signs of Overwork; Nature's Restoratives; Avocation; 
the Physiologic Necessity for Laughter; Vacations and Health; 
Sleep; Insomnia. 

The Eyes; Eye-strain; Description of the Visual Apparatus; 
Optical Defects and Their Correction; the Mechanism of Eye-strain; 
Local Symptoms of Eye-strain; Artificial Lighting; Hygienic 
Precautions in Reading and Sewing; Injuries to the Eyes; Symp- 
toms and Treatment of Conjunctivitis; Trachoma; Styes. 

Functional Nervous Disorders, Headache; Neurasthenia. 

The Brain the Master Organ of the Body.— The 

brain is not only the most important organ in the body, 
but its essential organ, for the sake of which all the other 
organs and tissues exist, and it is the master of the whole. 
It not only receives help from every other organ, but 
it also largely controls the working of each. By its mental 
action alone it can hurry the heart's beat or slow its pace ; 
it can make the skin shrivel or flush; it can quicken or 
stop digestion; it can stop or change the character of all 
secretions; it can arrest or improve the general nutrition. 
Every organ and every vital process is represented in the 
structure of the brain, by special centers and groups of 
cells that have a direct relation with such organs and 
processes, and through which they are controlled. 

The Functions of the Brain. — The brain may be said 
to have four chief functions; the first is that of motion; 
it presides over and stimulates all the voluntary muscular 
movements of the body, regulating their force, and co- 
ordinating in their working the different groups of muscles 

184 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 185 

needed to perform them. Mind and muscular movement 
have the closest possible connection with each other. 
The second function of the brain is that of feeling and 
sensation; the third is that of nutrition; through this 
its own nourishment and that of the rest of the body is 
regulated. While mind is the fourth and highest form 
of nerve force, it is not created in the brain, but is abso- 
lutely conditioned by that organ. 

Different groups of brain-cells have different work as- 
signed them; some have motion, some have sensation, 
some have nutrition, and some have mind. For example, 
special tracts of brain govern inhibition. While e very- 
group does its own work, it is related to and combined 
with others, influencing them, and being influenced by 
them. 

Every kind of mental activity uses up the brain energy 
of the cells. To think clearly, plenty of healthy blood 
must be supplied to the cells. In order to make healthy 
blood, there must be an abundance of fresh air supplied 
to the lungs, and a vigorous heart to pump it up to the 
brain. It has been demonstrated that, during intellectual 
work or emotional feeling, there is an increased supply of 
blood to the brain, which may become more or less con- 
gested, and that there is an actual rise of temperature; 
whereas during periods of relaxation, rest, or fatigue, the 
brain is pale and anemic. 

The brain-cells generally, but particularly those cells 
involved in mental activity, are of such a nature and con- 
stitution that they cannot rest absolutely during the 
waking hours. They may act slowly or with great 
rapidity; different brains have different capacities for 
energizing, both in regard to speed and force; and, 
further, the brain may be pushed to work greatly in excess 
of its normal activity, just as an engine may be allowed 
to go at the rate of 50 or 60 miles an hour, or may be 
pushed to go at the rate of 100 miles an hour. In both 
cases the danger resulting from speeding are greatly in 
excess of going at the normal rate of speed. 



186 PERSONAL HYGIENE FOR WOMEN 

In any case, the continuous brain action implies the 
necessity for continuous repair. The only complete 
physiologic rest which the brain enjoys is during sleep, 
when the process of repair goes on most rapidly; during 
this period the brain-cells absorb their nourishment from 
the blood in excess of their needs, and so lay up a store of 
energy for the waking hours. 

Habit and Automatism. — It is one of the innate 
qualities of every tissue and of every organ in the body, 
that when any vital action is performed, any vital proc- 
ess gone through with, it is easier to do it the second time, 
and the continuous exercise of the action makes the per- 
formances more and more easy, until they become auto- 
matic. 

The physiologic basis of habits consists of the plasticity 
of the nerve substance, and in the capacity of nerve sub- 
stance to receive and retain impressions. There results 
the certainty that the nervous system will act again 
more easily in those ways in which it has already acted. 

On the one hand, the automatic performance of work 
saves an enormous amount of brain energy; on the other 
hand, bad habits may be formed whose effects may be 
most pernicious, and which are gotten rid of only with the 
greatest difficulty. An example of the first is the young 
child learning to walk; at first he accomplishes the feat 
only by the fixed concentration of every power of the 
brain on the act; whereas the healthy adult walks 
automatically, without paying the least regard to the 
movements or the manner in which they are accomplished. 
Hysteria and ungovernable outbursts of passion furnish 
good examples of the bad habits that may be formed, 
owing to the lack of discipline and the powers of inhibi- 
tion ; every time that a woman gives way to one of these 
outbursts, so much the harder will it be for her to prevent 
or control another outbreak. Inhibition is the highest 
and most important function of the brain. 

Habits woman must have, but it is for her to choose 
what they shall be, provided she chooses quickly; the 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 187 

time limit in habits is one of the strong evidences of the 
close connection of body and mind. It is a startling fact to 
face, that a woman's habits are largely fixed before she 
is twenty; that the chief lines of her future growth and 
acquaintance before she is twenty-five; and her profes- 
sional habits before she is thirty; yet to something like 
this James believes that physiologic psychology points. 
The woman becomes a bundle of habits, and her habits 
settle about her like a plaster cast. 

The Physiology of the Brain and Nervous System. — 
The brain, spinal cord, and spinal nerves constitute the 
so-called cerebrospinal nervous system. The brain is 
that portion of the nervous system which is contained 
within the cranial cavity and which it completely fills. 
The spinal cord is the continuation downward, from the 
brain through the spinal canal, of nerve substances, and 
from which the spinal nerves are given off. The nerves 
may be described as cords and threads of varying degrees 
of fineness, distributed to every tissue and organ in the 
body. 

The nervous system has been likened to the electric 
telegraph, the brain being the central station, while, in 
addition to the special senses, the body is provided with 
numerous terminal substations in the skin and internal 
organs of the body, which keep the brain informed of 
what is going on in the world around it, as well as in the 
various parts of the body. The nerves simply act as 
conductors to transmit the messages. The body is 
supplied with two distinct sets of nerves or wires, one 
of which carries messages from the outside world and 
various organs to the brain, while the other set transmits 
orders from the brain. 

The spinal cord is the center of reflex acts; that is, 
if the leg of a brainless frog is touched with acid, he will 
take the other leg to wipe it off with. There are, as 
we have seen, substations in the skin, hence the acid 
causes the sensation of a foreign body, word is telegraphed 
the spinal cord, where there is a large central station; 



188 PERSONAL HYGIENE FOR WOMEN 

from here word is sent out by another set of nerves, to 
move the leg away from the acid, but this being insufficient, 
word is telegraphed to the other leg to wipe off the offend- 
ing substance. Did the same thing happen in the body, 
at the same time that the cord telegraphed word to the 
affected member to withdraw it, it would telegraph the 
brain, and the sensation of pain would be felt. 

A message travels along a nerve at the rate of about 
thirty-six yards a second, or a mile a minute. This is 
about the time made by a lightning express train. The 
distance in the body being so short, the time taken is 
imperceptible, and we say that movement is instantaneous. 

The paths traveled by nerve impulses are made passa- 
ble by use; the oftener an impulse traverses a given 
route, the more adapted such a route becomes for future 
traffic. 

But all of this has to do with the nerves which are 
under the control of the will. There is another set of 
telegraph wires in the body, called the sympathetic or 
vegetative system, so-called because it presides over 
the processes of nutrition and is beyond the control of 
the will. 

The Hygiene of Work. — Since the motor centers are 
located in the brain, it is natural to expect that all de- 
finitely directed movements will directly affect the brain 
and the mental development, and so it is. Du Bois 
Reymond says that it is easy to demonstrate that such 
bodily exercises as gymnastics, fencing, swimming, riding, 
dancing, and skating are much more exercises of the 
central nervous system, of the brain, and spinal cord than 
of the muscles. 

It is further urged that healthful energy of will is 
impossible without strong muscles, which are its organs, 
and that endurance, self-control, and great achievement 
all depend on muscle habits. 

The philosophy of work consists in its necessity. The 
brain-cell in health cannot cease to be active, except to 
a partial extent during sleep. There must be some output 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 189 

of mind from the mind cell and of motor stimulus from 
the motor cell. The proper selection of work for that 
particular brain to do, and the physiologic regulations 
of the work done, is the basis of the hygiene of work. 
For health, for happiness, and for efficiency, right work 
rightly done is the most important matter in any man's 
or any woman's life. 

The physiologic, as well as the moral necessity, has 
always been conceded for every man to have a life-work — 
a vocation ; a work for which he should be fitted, and 
for which he was capable, sufficiently congenial not to 
sink into mere drudgery, and which would, at the same 
time, afford ample financial compensation to be remunera- 
tive and a stimulus to his power of endurance. 

Important, from a physiologic point of view, as a 
vocation is for men, it is equally or even more important 
for women. It is highly probable that the unstable 
nervous system of women and their emotional extrava- 
gance and dissipations, whether of frivolity, wickedness, 
or grief, is largely due to lack of mental discipline and 
muscular development. It is a psychologic proposition 
that any woman who has a toothache suffers less if she 
keeps busy, and any one will testify that she suffers much 
less from the intense heat of summer if she is busily 
employed. 

One of the great objects of a definite and fixed occupa- 
tion is to turn the thoughts out from the ego. Work of 
some kind is indispensable to the health and happiness 
of every one, since it necessitates an objective instead of 
a subjective attitude of mind. 

Experience teaches that the brain, like the muscles, 
is subject to training; occasional excessive efforts, with 
long intervals of repose, are rather injurious, while a many- 
sided activity, constantly repeated, interrupted by suffici- 
ent shorter rests and supported by sufficient nutrition, 
is strengthening. A healthy training of the brain should 
be as many sided as possible. 

Symmetric development and training of every func- 



190 PERSONAL HYGIENE FOR WOMEN 

tion of the brain is as essential for mental efficiency and 
sanity as the development of all the muscles of the body 
is for bodily vigor, and a one-sided training of the mental 
powers is as certain to produce eccentricities of habits of 
thought and actions as those occupations which call 
into play only the action of certain groups of muscles is 
to cause bodily deformities. Anything which will prove 
injurious to the delicate nerve substance must be avoided, 
as laziness, idleness, and, worst of all, any form of nar- 
cotics. 

Many-sided life work, consistently carried through, not 
only strengthens the brain, but also its continued power 
of adaptation, and one's whole life is a continuous struggle 
for adaptation. The more the brain works, the more 
capable it is of receiving new impressions and elaborating 
old ones, and it retains its elasticity longer. 

Hurry generally implies lack of system in carrying out 
the routine of work, or the undertaking of more work 
than the individual can accomplish without injury to 
herself. Few things can more certainly muddle the brain 
and produce a sense of physical exhaustion than a sense 
of hurry. Without the sense of this insane driver with 
a lash in his hands standing over one, she can work more 
rapidly, with complete self-possession, and do more 
accurate and better work. The peculiar sense of being 
hurried has a direct benumbing physical effect, that can 
often be felt in the brain as distinctly confusing. 

The Toxins of Fatigue. — By speeding the machinery 
to the utmost, a strain is placed on nerves and muscles, 
and they are kept keyed up to the greatest possible ten- 
sion. There is a natural pace that one can keep up; 
force the pace, and weariness results. A man can go for 
hours at the rate of five miles an hour; he can run at 
the rate of six miles an hour for quite a long while; but 
if he tries to run eight miles an hour, he will drop out 
very soon. The powers of endurance must be gradually 
developed, but no machine should ever be run at its 
utmost speed. 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 191 

By undue pressure, at any period of life, it is possible 
to use up energy that ought to have been spread out over 
long periods; and this is emphatically the case during 
adolescence; too heavy a drain is made on futurity, 
which means a serious breakdown, or, at least, premature 
old age. 

It has long been assumed that during the activity of 
muscles substances were produced which exerted a 
poisonous influence upon the muscle tissues. Exactly 
what these substances were was not known, but it was 
supposed that they were definite products of metabolism 
or tissue waste. It is a well-known phenomenon, observed 
during the training of athletes and soldiers, that pro- 
longed and disciplined exercise makes it possible for 
individuals to support easily an amount of work which 
would prove exhausting or even fatal to the untrained. 
Increased work, under any circumstances, means increased 
metabolism, and consequently a more rapid accumulation 
of its products. 

A German investigator, Dr. Weichardt, has shown that 
if guinea-pigs were put upon a miniature treadmill and 
forced to run it until they dropped dead from exhaustion, 
a highly poisonous liquid could be pressed from their 
muscles, and that the injection of this liquid or extract 
into the veins of healthy guinea-pigs produced, when 
administered in small doses, rapid fatigue; whereas, 
larger doses caused death, accompanied by all the symp- 
toms observed in the original animal during the process 
of mechanical tiring. 

On the other hand, liquid taken from unworked guinea- 
pigs had no such effect. Further, that if these little 
animals were put upon a treadmill and worked to just 
short of exhaustion, and then were given time to re- 
cuperate, as we say, the liquid or extract from their 
muscles had no such effect: it was quite harmless. 

From the results of these carefully carried out scientific 
investigations, Weichardt has come to the conclusion 
that fatigue is due to a definite toxin, analogous to that 



192 PERSONAL HYGIENE FOR WOMEN 

of diphtheria and tetanus, and he believes that the ex- 
planation of the phenomena of training lies in ,the fact 
that in the body of the athlete there must be a specific 
" antibody/' which neutralizes the "fatigue toxin" as 
soon as it is formed. 

In the animals undergoing these experiments of extreme 
fatigue there was a fall of temperature. A practical use 
of this fact could be made for the individual, by noting 
the fact that a subnormal temperature was a grave 
danger-signal. 

Other observers concede that fatigue is due to chemical 
substances, produced in the body as the result of brain 
and muscle activity, and find that these toxins produce 
a depressing effect, especially on the muscular system, 
and that the sensation of fatigue is in large part the 
manifestation of this depression. The action of toxins 
is not confined to the tissues in which they arise; exces- 
sive activity of one tissue can cause fatigue of others. 
The facts of acid intoxication are noticed as analogous 
to fatigue phenomena, so far as the latter are due to 
toxic substances. As antidotes, only rest and sleep can 
be relied upon. 

Observations in the electric experiments on nerve-cells 
have shown a remarkable shrinking of the nerve-cells, 
and especially of their nuclei. After five hours' con- 
tinuous work, the cell nucleus was only half its normal 
size, and twenty-four hours of rest was necessary in order 
to restore it to its normal size, but half that amount of 
work does not require half that amount of time for its 
recovery. 

The mental symptoms of normal fatigue are loss of 
memory; the sense of perception is less acute; the associa- 
tion centers act less spontaneously and therefore slower; 
the vocabulary diminishes; the emotional tone is lowered; 
the attention is unstable and flickering. All these are 
marked symptoms that the individual is far below her 
best. All kinds of perceptions are more acute in the 
morning. 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 193 

Fatigue is not, therefore, merely physically uncom- 
fortable; it is intellectually, physically, and morally 
dangerous. 

Overwork. — A surplus nervous energy must be per- 
sistently aimed at — what Emerson calls "plus health." 
It must be indelibly impressed on the intelligence of 
every one that no fatigued individual can be at her best; 
she is doomed to do inferior work, to be mentally de- 
pressed, and to be morally weakened. Hope and courage 
ooze away, and all sense of proportions and perspective 
are lost. 

The amount of work that can be performed without 
fatigue is a matter of individuality, and the only safe 
gauge of overwork are the danger-signals sent out by 
nature — loss of appetite, insomnia, increasing exhaustion 
from day to day without increase in the amount of work 
done, mental depression, lack of interest and initiative. 
No one can afford to disregard these danger-signals. 

Habitual overwork produces fag and a desire for 
stimulants to act as a spur to the overworked muscles 
during the day, and recourse to increased stimulants or 
sedatives to act as hypnotics at night. The inert nerve- 
centers have no reserve energy to give out, so it is worse 
than useless to stimulate them. On the other hand, 
the nerve-centers are at too low an ebb to react from 
the depressing effects of sedatives, which, to the indi- 
vidual, must be positively injurious. The aim must be 
to promote nutrition, and to give complete rest to the 
exhausted nerve-centers. 

Brain work, to be beneficial, must be regulated with the 
greatest care. During the exercise of the brain there 
is always an increased blood-supply to it. If the exercise 
is continued too long, there is a tendency for the blood 
to remain in too great quantity, due to the exhaustion 
of the nerve-cells, which are no longer able to control the 
vessels. 

During sleep the blood-supply to the brain is diminished 
and the cells recover themselves, but if this hyperemia 

13 



194 PERSONAL HYGIENE FOR WOMEN 

be persistently kept up, sleep soon becomes impossible, 
the brain-cells have no opportunity to become repaired, 
and their activity is diminished. 

Richardson says: "Making all allowances for differences, 
even in the prime of their mental and physical vigor, 
few individuals can exceed six, and for most persons 
prudence would direct not more than four or five hours 
of close mental application, without seriously endanger- 
ing their health." 

No real advantage is gained by eight or ten hours of 
daily study, since the memory and reasoning powers 
become so exhausted that the assimilation of ideas 
becomes slower and more difficult. When in his prime, 
Walter Scott declared that six hours a day was all that 
he could profitably spend upon his literary compositions. 
In later years, because of his pecuniary embarrassment, 
he worked beyond this limit, and, as the result of exces- 
sive labor, his last years were spent in hopeless imbecility. 

Signs of Overwork. — These show themselves in 
irritability, with a sense of exhaustion, the irritability 
being due to an exhaustion of the nerve-centers. Work 
becomes irksome. There are periods of depression and 
melancholia, which recur at shorter and shorter intervals 
and continue for a longer period of time. There is a slight 
loss of memory, together with inability to concentrate 
the mind upon any given subject for any considerable 
length of time, and the power of thought and judgment 
are impaired. There are sleepless nights, ringing in the 
ears, fatigue from the slightest exertion, an irregular 
action of the heart, with palpitation and a frequent desire 
to urinate. Various forms of pain and neuralgia occur. 

There may be as yet no loss of flesh or impairment of 
the appetite, but this condition of cerebral anemia 
furnishes the possessor with a pair of blue spectacles 
through which the intelligence must look, and which throw 
their own color over everything. Distressing dreams 
and unrefreshing sleep allow the brain little opportunity 
for either rest or repair. The mind becomes as sensitive 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 195 

as the skin after a blister, and the calm, vigorous mental 
labor is superseded by feverish anxiety, wearing responsi- 
bility, and vexing chagrin. 

When the brain is well supplied with a powerful circula- 
tion, and a rich blood-supply from a good digestion 
furnishes it with an abundance of pabulum, the cares of 
life are borne with equanimity and cheerfulness. One 
of the most unerring signs of failing health is the inability 
to withstand the pressure of these same daily cares. 
When the cares that formerly sat lightly on the shoulders 
become well-nigh an insupportable burden, a state has been 
reached where the mind reacts on the body. 

Worry. — It is readily evident that worry is bred of 
exhaustion, and is one of the signs of overwork; but, if 
too often indulged in, it becomes a fixed habit, and the 
mind rapidly becomes settled in a state of gloom. 

It is most important for overwrought business and 
professional women, but most especially for those women 
whose vocations in life combine three distinct occupa- 
tions or callings — namely, wives who act in the capacity 
of housekeepers, ministers of finance to the household, 
and the bringing up of children — to realize the importance 
of not undertaking more than they can accomplish with- 
out fret and worry. The overconscientious woman may 
object that it is selfish to consider her own comfort 
when she has work to do for others, but to expend too 
freely of the nervous energy, even in a good cause, is like 
giving so much of our substance to charity that we our- 
selves are in turn obliged to lean on others for support. 
In properly conserving our own energies, we may ulti- 
mately be lightening the burden of others. There is a 
proper balance between the duty one owes to one's self 
and to others. 

Once bred, worry is an endless chain. Tell such a 
woman not to worry, and she worries for fear she may 
worry. She is afraid that she has decided wrongly, and 
regards decisions in regard to the most trivial affairs of 
life as though they were matters of vital importance. 



196 PERSONAL HYGIENE FOR WOMEN 

The obsession "to arrive" is a fertile source of fret and 
worry. This habit of mind leads to frantic and incessant 
labor and blocks all pleasure at every point. The person 
who plays a game only to see who wins, loses half of the 
benefit of the recreation. 

"The legs of the stork are long, the legs of the duck 
are short; you cannot make the legs of the stork short, 
neither can you make the legs of the duck long. Why 
worry?" (Chinese proverb.) 

Insomnia. — This is another symptom of overwork. 
The mind, worried and harassed all day, retires at night 
to struggle in the darkness and solitude with worries, 
forebodings, doubts, and regrets, which now assume 
gigantic and fantastic shapes. In this case the insomnia 
is due to faulty habits of mind. 

Another form of insomnia is caused by intellectual 
work being carried on at night until time for retiring; 
the mind is then so fully saturated with the subject 
that it is unable to throw it off on going to bed. 

Whatever be the cause of the insomnia, it soon becomes 
a fixed habit, and, whether it is a case of laying awake a 
long time before sleep comes, or waking up at a regular 
hour toward morning,— and it is a curious fact that the 
habit of waking up recurs at almost precisely the same 
hour in the morning, — the longer this habit of insomnia 
is indulged in, the more difficult it is to break it up. 

Nervousness. — This is a well-known sign of overwork, 
which shows itself in intense nervousness and irritability. 
Everything jars on the nerves. The woman gives way 
to her emotions, over which she loses control. 

To keep placid when overworked to the limit of physical 
endurance requires a stolidity of soul and lack of nerves 
only known to the North American Indians, and perhaps 
the Japanese, and it matters not what the kind of over- 
work is, whether business, pleasure, or charity. 

Nature's Restoratives. — The proper division of the 
day is eight hours to be alloted to work, eight to sleep, 
and the remaining period of eight hours is to be divided 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 197 

among the various methods of refreshing body and mind 
— the toilet, eating, rest, and recreations. 

Not only are rest, recreation, and sleep in proper 
proportions essential to the health of the body, but 
they are equally essential to the quantity and the quality 
of the output of work. From them result a feeling of 
physical well-being, an exuberance of animal spirits 
which go into the work. The perspective is more ac- 
curate, the judgment is clearer, and the creative power is 
greater. Work goes of itself with a swing. Happiness 
is an expansive quality, that makes itself felt throughout 
the entire body, but its effects are most manifest in the 
mental power. 

The mother who so honestly works and plans for the 
good of her family as to give herself no time to rest after 
her physical efforts is in such an exhausted condition 
as only to be able to give them the tired and critical side 
of herself for daily association. There are few human 
achievements much finer than to make human beings 
happy, and this power woman is endowed with to a very 
large extent. 

Rest, to be of value, must be systematically taken. 
Bearing in mind the shrinking in size of the nerve-cells 
after stimulation caused by work, and that they recovered 
their normal size in relatively less time if the shrinkage 
were less, it becomes obvious that, in order to accomplish 
the best work, whether purely mental, or of the more 
complex mental and physical work demanded of the 
mother who is at the same time the housewife, that a 
break in the day's work will aid in securing the best 
results. 

The exact time of the daily siesta must be adapted to 
the family regime, but a fixed hour should be set aside 
for this purpose, and this should be known as the mother's 
hour, and nothing short of a catastrophe should be allowed 
to infringe on it. 

The woman should retire to her bed-room, undress, 
and go to bed. The room should be darkened, and at 



198 PERSONAL HYGIENE FOR WOMEN 

the same time there must be an abundant supply of fresh 
air. One soon forms the habit of taking a short nap, of 
perhaps half an hour; one hour should be spent in bed. 
After this, she gets up, takes a shower or other bath, 
dresses, and is then ready to enjoy life and be a comfort 
to her family. In this way alone can absolute relaxation, 
rest of mind, and body be secured. 

Avocation. — Second only to the physiologic necessity 
for a vocation in life, is the necessity for an avocation, 
and this must he in the nature of a recreation. 

It is a well-known fact in farming that any one kind 
of crop will exhaust the very best soil, but few people 
recognize the necessity for a change of occupation and 
recreation in order to produce the best mental and 
physical results. 

Joyless drudgery drains the springs of health. There is 
a mental starvation, due to the lack of recreation, as well 
as the physical, due to the lack of bread. The French aris- 
tocrats, noted for the gaiety of their pastimes, in spite 
of their dietetic and other sins, furnish a remarkable list 
of longevity. Persons of a cheerful disposition are 
generally long-lived, and anything tending to counter- 
act the influence of worry and discontent directly con- 
tributes to the preservation of the health. Despair, which 
frequently results from years of overwork, can paralyze 
the energies of vital functions like a sudden poison, while 
hope fulfilled has cured many a disease. 

The nature of the avocation chosen will necessarily 
depend upon the character of the vocation. For women 
whose vocations are intellectual and sedentary, as writers, 
teachers, stenographers, etc., some outdoor employment, 
which calls into activity the muscles of the body, rests 
the eyes and brain, and, at the same time, pleasantly 
occupies the mind, is the best, as walking, gardening, 
lawn-tennis, golf, rowing, etc. 

For all women engaged in sedentary occupations, daily 
exercise in the open air is the first essential, and let them 
be assured that their feelings of fatigue and disinclination 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 199 

to exercise are no safe guide as to their ability to take 
exercise. 

The first cause of the feeling of fatigue is due to the 
lack of oxygen in the lungs and the impure air of the 
room. On going out-of-doors, the woman will be surprised 
at how much stronger and better she feels after an hour's 
brisk walk than she did on starting out. 

"Fancy work" and lace-making, instead of being 
classed with recreations, must be classed with fine hand- 
sewing of the most taxing kind. It calls the same groups 
of muscles into play, and is productive of the same evils, 
with a greater tendency to produce eye-strain and a 
paralysis similar to writer's cramp. 

The proper avocation of the tired housewife, who has 
been on her feet all the time and whose vocation is manual 
labor, will be the diversion of the mind by reading a 
good book, while comfortably pillowed on a veranda 
chair, a drive, a visit to some congenial friend, a game of 
cards, or music. 

Literary clubs for women should be more largely organ- 
ized through the country and in country towns. In the 
cities women have found these clubs a great boon, not 
only to the health and happiness, but they are in the 
highest degree educational. 

Further, women have found that these literary clubs 
were profitable, as a means of bringing their minds in 
contact with other educated minds, and thus they had 
not only the additional stimulus to study, but a broaden- 
ing of their horizon, which the woman's heretofore shut- 
in household life had precluded. Courses in domestic 
science would be a boon to the home. 

The greater the number of interests which education 
and culture have created, the greater will be the diversity 
of the recreations open for the woman's enjoyment. 

Care must be taken that the avocation, which is at first 
an enjoyment and relaxation, is not turned into hard 
labor. The moment that any one strains every nerve, 



200 PERSONAL HYGIENE FOR WOMEN 

even to excel in a game, that moment it ceases to be a 
relaxation. 

History shows that the laws of all nations have always 
provided a certain number of days of rest, or at least a 
change of occupation, and that these days were fixed at 
more or less regular intervals. This was partly from a 
religious and partly from a hygienic standpoint. The 
necessity for the interruption of the regular routine work 
has always been recognized, and one day out of every 
seven has been set aside for this purpose. 

The custom that is so frequently adopted by city folk 
of going out of town over Sunday might very well be 
imitated by country folk by going into the town or city 
over Sunday. For not only is the too continuous applica- 
tion to one's employment fraught with danger, but it 
has been conclusively shown that a monotonous routine 
of occupation, such as lived by the average farmer's wife, 
is a severe tax on the sanity of the mind. Statistics show 
that the heaviest percentage of insanity falls on farmer's 
wives, and the supposed cause of this is the monotony of 
their lives. 

A horse cannot gallop as many hours as it can walk, 
and the daily task should be the sum-total of what man 
or beast can do compatibly with health. To combine 
a day of toil with a second of amusement in one twenty- 
four hours does not give the proper allowance for sleep, 
and cannot be done without injury to the individual. 

Fun and laughter are the most efficacious remedies in 
the pharmacopeia, and tired humanity owes a debt of 
gratitude to the guild of humorists, be they writers, 
comedians, or musical composers. 

The Physiologic Necessity for Laughter. — The at- 
titude of the individual varies with age, temperament, 
and the perspective of life. Grave adults are apt to think 
of laughter and smiling as something occasional, a momen- 
tary lapse once in a while from the persistent attitude of 
seriousness. Healthy children, on the contrary, consider 
that a state of laughter is the normal condition of human* 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 201 

ity, and that seriousness is a tiresome necessity, which 
must be tolerated from time to time. But very few people 
have any idea that there exists a well-defined physiologic 
necessity for laughter, and the greater the intellectual labor 
and the mental strain, the greater is this necessity. 

The deep forcible chest movements increase the rapidity 
of the circulation, the force of the heart's beat, and secures 
a more complete oxygenation of the blood. 

It is not improbable that this accelerated circulation 
produces remote effects on the organism. One of the im- 
mediate effects of a good laugh is that it relieves the brain 
by the rapidity of the movements of the blood through 
the capillary circulation. 

In addition to the immediate physiologic effects which 
result from laughter it is highly beneficial, by relieving 
the brain and nervous system from the intense strain 
and tension of the daily affairs and occupations of life, 
and gives relief to the severely congested capillaries, which 
otherwise involve considerable risk to the individual. 

Physiologists hold that pleasurable feelings tend to 
further the whole group of organic functions, and that 
laughter produces a considerable increase of vital activity 
by the heightened nervous stimulation. There is a sense 
of increased energy, of a high tide of the fulness of the life 
current. 

Vacations and Health. — The secret of success of the 
old Romans in conquering the world lay as much in their 
ability to maintain the health of their troops in their va- 
rious campaigns as by the courage and organization of 
those troops; or, rather it may be said that courage is 
but the coefficient of a good physique and a general men- 
tal vigor. 

A rest one day out of seven, with an occasional outing 
for the week-end, is good but not sufficient. If one would 
keep up to her highest standard of physical and mental 
efficiency, she must have at least one month of absolute 
change of environment and outdoor life in the year. 

The kind of place one choses for her vacation will 



202 PERSONAL HYGIENE FOR WOMEN 

depend on where her home is. To dwellers in cities, the 
mountains and seaside resorts are the most beneficial. 
August is our most trying month, and every one who can 
would do well to take her vacation at that time, always 
selecting some resort north of her own home, so that she 
may have the additional advantage of a more bracing 
climate. 

Maine furnishes many of the most beneficial of our 
health resorts, combining as it does so many attractions — 
its bracing atmosphere of pine forests, its beautiful 
scenery with vast expanses of water, and the great variety 
of diversions which it affords. 

It is always wise to send an advance scout to investigate 
the place in which you contemplate spending your vaca- 
tion. Avoid low and swampy land; investigate the 
character of the water-supply and the nature of the 
plumbing, together with the sewerage system, for it is 
all too frequent that an attack of typhoid fever follows 
an outing in the country. Every good summer resort 
should furnish facilities for a variety of outdoor sports — 
golf, tennis, boating, swimming, etc. 

During the vacation needless exposure to the direct 
rays of the sun must be avoided. There is probably 
nothing which lowers the vital resistance, and so prepares 
the way for disease as much as exhausting exposure to the 
hot rays of the sun. 

Long hours of sleep should be indulged in. The morn- 
ing air is the most beneficial; it is, therefore, a good habit to 
retire early and to rise early. 

If the vacation is not properly spent, it may be the 
means of doing more harm than good. On the other 
hand, if properly spent, vacations prepare one as nothing 
else can to meet and resist the vicissitudes of the follow- 
ing winter. It is the people who go off on long vacations 
who have the least need of the doctor's care. 

Sleep. — During sleep all the bodily functions are in 
abeyance and the secretions are diminished; respiration 
is slow and confined to the chest, so that the amount of 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 203 

inspired air is only one-seventh of that during the waking 
hours; the temperature of the body falls; less blood 
circulates through the brain; and the sensibility of the 
nerves to external stimuli is diminished. Sleep is not 
only par excellence the time of repose and recuperation 
of the brain and nerve substance, but it is the only time 
when, by the diminution of waste caused by the incessant 
activity of the brain, that the organ can be properly 
nourished, the deficit in nerve force canceled, and the 
surplus of energy stored up. 

Without this absolute remission of brain activity every 
twenty-four hours an actual destruction of substance 
would occur, which, if persisted in, would be so depressing 
to the nervous functions as to be inconsistent with life, 
and this is the case in the concluding stages of fatal 
diseases. 

The sleepy feeling caused by fatigue is due to the 
circulation in the blood of toxins resulting from tissue 
waste, which benumb the brain-cells; while the feeling 
of freshness and bien-etre with which one awakens in the 
morning is due to the elimination of the fatigue products 
from the blood during sleep. If the blood of a tired 
dog be transfused into the veins of a perfectly fresh animal, 
the latter will immediately show symptoms of somnolence 
and seek a dark corner for sleep. 

The medical authorities of to-day are pretty well agreed 
that eight hours of sleep is the minimum required for the 
maintenance of health, and all concede that the brain- 
worker requires more sleep than the manual laborer. 
Every moment after the feeling of languor presents itself 
is a strain upon the nerves and muscles which will sooner 
or later invalidate for life, and finally bring the victim 
to a premature grave. Habitual deficiency of sleep will 
undermine the strongest constitution. 

It is a matter of great importance to train one's self 
in the habits of sleep, regularity in the hour of retiring, 
abstinence from active brain work for the hour immediately 
preceding going to bed, since, if active brain work is con- 



204 PERSONAL HYGIENE FOR WOMEN 

tinued until one goes to her room for the night, the chances 
are that the brain will continue its activities after getting 
into bed, and sleep may be banished from the pillow 
for several hours. 

A few minutes spent in breathing exercises, the vigorous 
use of the flesh brush or hair glove, a hot plunge or foot- 
bath are no mean hypnotics. 

A sound sleep is dreamless. Dreams require a certain 
expenditure of nerve force and mental energy, so that 
dreamless sleep is the most restful. Disagreeable dreams 
and "night-mares" are generally associated with indiges- 
tion and biliousness, which also occasion a general rest- 
lessness. All this can be overcome by taking some med- 
icine for the liver. Two grains of calomel taken just 
before retiring often works like a charm. The dose must 
not be repeated under a month. In case of tendency to 
insomnia, no coffee should be taken after breakfast. 

Treatment of Insomnia. — The mechanical measures 
for the relief of insomnia have for their purpose the with- 
drawing of the blood from the brain to the surface of the 
skin. Hot foot-baths; general warm baths; cold douches 
to the spine, brisk exercise; light massage, and cold rooms. 
Mental work should be laid aside several hours before 
retiring; late suppers avoided; coffee, if taken at all, 
should only be taken for breakfast, and then only one 
cup. Reading or amusement should be selected that 
does not excite the nerves. 

To woo sleep the woman should put herself in a position 
of rest, which of itself physiologically induces sleep. 
Avoid irritations, noises, bad air, cold feet, overloaded 
bowels, all of which tend to wakefulness and to prevent 
the proper physical rest. Then sleep usually comes of 
itself. 

The Eyes : Eye-strain. — Of all the misfortunes that 
could befall a human being, the loss of sight is probably 
the greatest, and yet no organ of the body is so constantly 
abused as the eye. 

The trouble is that the possessor of the normal eye 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 205 

does not take into consideration that in all near work, as 
in reading, writing, sewing, etc., the eye is actively 
engaged as well as the hands and brain, and that the eye 
only is at rest when looking into space or when closed. 

Description of the Visual Apparatus. — The eyeball 
is contained and protected in a bony cavity, formed by 
the bones of the face and skull, and is supported by a 
cushion of fat and other tissues. It is held in place by 
its membranes and muscles, by which it is also moved. 
It is further protected by the eyelids, the eyebrows, and 
the eyelashes. The eyebrows protect the eyes from 
dust and perspiration and shade the eyes. 

The eyelids are lined by a very delicate mucous mem- 
brane, called the conjunctiva. They are maintained in 
close apposition to the eyeball by atmospheric pressure. 
The tears are secreted by the lacrimal gland, which is 
at the upper and outer angle of the orbit. The lubrica- 
tion by the tears and the mucus secreted by the con- 
junctiva cause them to move smoothly and without fric- 
tion. An important function of the lids is to distribute 
the tears over the front of the eyeball, and by incessant 
winking to free the front of the eye from dust and to keep 
it moist. 

The conjunctiva is continuous with the mucous mem- 
brane of the nose and mouth. Hence, in inflammation 
of the nasal mucous membrane, as in an ordinary cold in 
the head or influenza, the conjunctiva is liable to become 
very much congested or inflamed. 

The eyeball is spherical in form, having the segment of 
a smaller and much more prominent sphere ingrafted on 
its anterior part. The segment of the larger sphere, which 
forms about five-sixths of the globe, is opaque, and forms 
the sclerotic coat, the so-called "white" of the eye. The 
smaller sphere, which forms the remaining sixth, is trans- 
parent, and is formed by the cornea. 

The iris is a circular contracting membrane, suspended 
from the edges of the cornea, in front of the eye like a 
curtain. The iris gives color to the eye, and when we 



206 PERSONAL HYGIENE FOR WOMEN 

say that an eye is blue or brown, we mean that is the color 
of the iris. The iris is freely movable, and, according as 
to whether it dilates or contracts, there is an alteration 
in the size of the central aperture, called the pupil. 

The chief function of the iris is to regulate the quantity 
of light admitted to the interior of the eye. In a very strong 
light the pupil quickly contracts, shutting out the exces- 
sive light, while in a subdued light the pupil dilates, thus 
allowing more light to enter. When looking at a distance 
or when looking languidly into space, the pupil dilates. 

The Formation of the Image. — The eye is a camera, con- 
sisting of a series of lenses and media arranged in a dark 
chamber, the iris serving as a curtain. The object of the 
apparatus is to form on the retina a distinct image of 
external objects. 

The Mechanism of Accommodation. — In the passive 
condition of the eye, when it is adjusted for far objects, 
the anterior surface of the lens is somewhat flattened. 
Accommodation for near objects consists in a contraction 
of the circular ciliary muscle and an increase in the con- 
vexity of the anterior surface of the crystalline lens. 

The light enters the eyeball through the pupil, falls 
upon the retina, which has often been compared to the 
sensitive plate of a camera,- is received and transmitted 
by the optic nerve to the visual centers of the brain. 
The eyeball does not see. It is only a sensitive end-organ, 
which receives and transmits the impressions to the 
higher centers of sight. The act of vision is performed 
in the brain. 

The focusing power of the eye is the property of bend- 
ing nearly parallel rays of light from distant and divergent 
rays or from close range so that they meet exactly on the 
sensitive retina; this is called refraction. In the normal 
eye these rays are focused exactly on the retina. 

Optical Defects and their Correction. — In the norma) 
eye the near limit of accommodation is from 4 to 5 inches, 
and the far limit may be put at an infinite distance. 

Myopia or Near-sightedness. — This is one of the most 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 207 

common refractive defects of the eye. In this condition, 
because of the greater length of the eyeball or increased 
refractive changes of the media, rays of light from a 
distance are focused in front of the retina, producing an 
indistinct image. 

The near-point is brought much nearer — from 2 to 2J 
inches — and the far limit is at a very short distance. 

In reading, the myope is obliged to hold her book very 
close to the eyes in order to see. In doing so, she strains 
her muscles of convergence, producing ocular congestion 
and compression of the eyeball. 

The predisposing causes of myopia are heredity; it is 
said that half of myopics are descended from near- 
sighted parents; uncorrected astigmatism, and the effort 
to read very fine print or figures, entails severe strain on 
the eyes, which may result in myopia. 

Myopia is corrected by a concave lens, which diverges 
the rays of fight, prolonging the focal distance, so that 
the rays of light are focused exactly on the retina. 

Not only are myopic eyes not injured by wearing suit- 
able glasses, but, on the contrary, are often preserved 
from injurious pressure on the globe, due to the indul- 
gence of the habit to nearly close the lids in order to see 
better, as is commonly done when glasses are not worn. 

Hyperopia or Far-sightedness. — In this condition the eye- 
ball is too short, and the rays of light from a distance 
are focused behind the retina. Instead of being distinct, 
the image is blurred. Hyperopia is corrected by a convex 
lens, which converges the rays of light, bringing them 
sooner to a focus. In the hyperopic eye the near-point 
of accommodation is at some distance, and a far limit of 
accommodation practically does not exist. 

Presbyopia. — This is a loss of the power of accom- 
modation, by which reading, writing, sewing, and other 
near work is accomplished. This power of accommoda- 
tion is greatest in early life, and gradually diminishes 
until about the age of forty years, when reading at the 
ordinary distance becomes uncomfortable. At about 



208 



PERSONAL HYGIENE FOR WOMEN 



seventy-five years of age the power of accommodation 
is practically lost. 

Every person over forty-five years, with normal or far- 
sighted eyes, should wear glasses to perform near work. 

Astigmatism. — Astigmatism does not depend on the 
length of the eyeball, but on the curvature of the cornea, 
and rarely on that of the lens. Uncorrected astigmatism 
necessitates the expenditure of more muscular effort in 
the attempt to see distinctly than is necessary when 




Fig. 12. — Astigmatic chart. 



refraction is normal. This is accompanied by early 
fatigue and more or less congestion of the vascular tunics 
of the eye. Astigmatism is corrected by a cylindric lens, 
which has a plane surface in one axis and a concave 
surface in the axis at right angles to it. 

In simple astigmatism, on looking at the accompany- 
ing astigmatic chart with each eye separately, certain lines 
in the defective meridian seem very much blurred, while 
those at exact right angles appear clear and black. This 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 209 

furnishes a test for astigmatism, since to the normal eye 
the lines appear of equal distinctness and clearness. 
Astigmatism is a very common ocular defect. 

The Mechanism of Eye-strain. — Comparatively few 
eyes are perfect. Far-sighted or astigmatic eyes can 
secure perfect vision by means of accommodation. By 
constant strain on the ciliary muscle, the crystalline lens 
is so increased in curvature as to exactly counterbalance 
the optical defect of the eyes. 

Healthy eyes should do their work without the con- 
sciousness of the owner, and this is a safe test as to the 
kind and amount of work demanded of them. 

Perfect rest for the eyes is impossible in the waking 
state — distant vision represents rest for the eyes and near 
vision exertion. 

Near work is the chief cause of near-sightedness. 
Distant vision should alternate with near work, and in 
near work the object should not be brought nearer to the 
eyes than 12 inches. 

The Local Symptoms of Eye-strain. — There may be 
a sense of fatigue in the eyes after reading for a short 
time, and this may be followed by a constant sense of 
discomfort in the eyes, which is increased on using them, 
and which may be accompanied by severe pain in the 
back of the head. There is a sensitiveness to light, and 
inflammation of the eyelids and conjunctiva. There may 
be twitching of the eyelids, and in extreme cases difficulty 
in keeping the eyes open on account of drowsiness. The 
eyes may smart, itch, or burn, and continually "water." 

As the trouble becomes more pronounced, reading 
for a short time may be followed by a blurring of the 
type, and finally the lines may run together. There is 
a constant sense of the eyes feeling for the lines, and, 
perhaps one of the first things to call attention to the 
condition of the eyes may be the losing of the lines in 
reading. 

The general or reflex symptom of eye-strain is head- 
ache, which frequently takes the form of migraine. This 

14 



210 PERSONAL HYGIENE FOR WOMEN 

is increased on reading, sewing, riding in the cars, etc. 
The headache is usually over the region of the temples 
or just above the eyes, but it may be on the top of the 
head or at the base of the skull. 

Vision is so fundamentally related to all the brain func- 
tions that eye-strain, or anything which interferes with 
normal sight, may cause the most varied disturbances 
of bodily functions. 

The Prevention of Eye-strain. — Persons whose work 
necessitates much ocular labor should vary their duties 
with intervals of rest. In continued reading or sewing 
it is well to desist at short intervals and fix the gaze on some 
distant object, and to frequently close the lids. 

Lace work, very fine needle work, working on black 
goods, reading very fine print, or print on an inferior 
quality of paper, or attempting to read in a dim light, are 
all a severe tax on the eyes, and should be avoided, 
as they are certain to cause them permanent injury. 

Defective vision is so common in school-children, it is 
so often present without being suspected, and so much 
harm is done to the eyes and the general health of the 
individual before it is discovered, that there should be 
a compulsory law requiring the examination of all school- 
children; and, again, before boys and girls enter the 
normal schools and colleges. 

Clear vision gives clear judgment; defective vision in its 
various manifestations gives different warps and bents 
to the mind of their unfortunate possessors. 

Veils. — The wearing of veils is responsible for not a 
little deterioration of vision, particularly when they are 
thick or dotted. Unless the meshes of the veil are very 
large, it holds a layer of impure air close to the face, so 
that the wearer is breathing vitiated air. It hinders 
clearness of vision, because the external world is viewed 
through a narrow lattice. 

The best veil for the eyes is one with a single mesh, 
either without dots, or the dots so far apart that none 
shall come over the eyes. 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 211 

Protection of the Eyes from the Glare of the Sun. — In very- 
hot weather the eyes should always be so protected that 
the rays of the sun do not shine directly into them. This 
protection may be afforded by the brim of the hat or by a 
parasol. At the sea-shore, or on an ocean voyage, where 
the glare of the sun is constant and particularly trying, 
the eyes should be protected by wearing slightly tinted 
smoked glasses. 

Artificial Lighting. — The main sources of artificial 
lighting are kerosene, gas, and electricity. The principal 
questions of importance are the quantity and quality of 
the light, its steadiness, the vitiation of the atmosphere 
by the products of combustion, and the expense; also the 
proper arrangement of the light. 

Kerosene is the most extensively used means for arti- 
ficial fighting. The principal objections are — the heat, 
the trouble of filling and keeping the lamps in order, and 
the danger of explosion and fire if upset; the odor and 
the great vitiation of the atmosphere. 

The modern lamp gives a brilliant fight, and if prop- 
erly shaded by a slightly bluish chimney, so as to absorb 
the excess of yellow rays, it is very satisfactory. 

Illuminating gas, as furnished in cities, has a great 
excess of yellow rays, which are very injurious to the eyes, 
and the vitiation of the atmosphere is very considerable. 
Gas-light is modified by the Argand and Bunsen burners. 
Of these, the Bunsen burner, a patented composition 
burner, heated to incandescence, is the best. It gives a 
white light, resembling daylight, and, under proper adjust- 
ment, a far greater volume than any other burner. It is 
not so hot, does not consume as much gas, and so there is 
less vitiation of the atmosphere. It is intensely brilliant, 
and must be shaded by ground glass or a proper shade. 

Electricity gives the very best light, with a minimum 
amount of heat and vitiation of the atmosphere. For 
individual use 16-candle power is sufficient. 

The lamp-shade should be opaque, of a dark-green color, 
and lined with a white, reflecting surface. Transparent 



212 PERSONAL HYGIENE FOR WOMEN 

lamp-shades, especially when patterned, are always bad, 
whatever their color; because of the different degree of 
illumination thrown upon the work, the light is irritating 
to the eyes. 

Hygienic Precautions in Reading and Sewing. — 
There should be free access of open daylight. Near the 
window is obviously the best place for working, and the 
seat should be so selected that the window is to the left of 
the worker. This prevents the work from being shaded 
by the hand, and protects the eyes from being fatigued 
by the light falling directly into them. 

Any room will have too much light into which the sun 
shines directly. Even if the worker's face is not turned 
directly toward the sun, yet the light reflected from the 
book or other work will be so intense as to be dazzling. 
The softest and most pleasant light to work by is the 
diffused light from the northern sky. An excess of 
light may be easily regulated by a shade. 

Reading. — -Very fine type should always be avoided, 
it is a very unnecessary strain on the eyes, as are also 
books printed on a poor quality of paper with improper 
spacing. The paper should be unglazed. 

Length of Line. — The length of the printed line should 
not be more than 4 inches, nor less than 2} inches; that 
is, not more than 10 or less than 7 centimeters. If the 
line is too long, the effort to find the succeeding line is 
too great. If, on the other hand, the line is too short, 
the lateral movements of the eye are so frequent that the 
muscles concerned in these movements soon become 
fatigued. 

The position of the reader should be sitting upright, 
with the back toward the light, which should fall over the 
left shoulder, and the book held nearly on a level with 
the eyes. The book should be held at a distance of about 
12 inches from the eyes. The light should be on a level 
with the head or slightly above it. In desk work, a shade 
should always be worn to protect the eyes. 

Reading in the recumbent position is a pernicious habit, 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 213 

and is particularly bad when convalescing from an illness 
or when very tired. 

Reading in carriages or cars is injurious to all eyes, 
but especially so to myopic eyes; because of the constant 
jolting, the distance between the type and the eyes is 
continually changing, necessitating the frequent and 
abrupt adjustments of accommodation; besides, the 
illumination is apt to be very poor. Reading in a dim 
light or the twilight is also very bad for the eyes. 

Sewing and embroidery require the most trying ocular 
labor and the best conditions for illumination. Working 
on black goods by artificial light should be absolutely 
forbidden. 

Injuries to the Eyes. — The most common injuries to 
the eyes are the entrance of small particles of dust, cinders, 
steel filings, etc., into the conjunctival sac, or into the 
substance of the cornea. Frequently, with the aid of a 
little winking, the tears wash away these foreign sub- 
stances, but if the susbtance lodges in the lining mem- 
brane of the upper or lower lid, or is imbedded in the 
cornea, it may be necessary to resort to other means in 
order to remove them. 

The lining membrane of the lower lid is brought into 
view by simple tension of the lower lid downward by one 
finger. If the offending particle is not seen, the upper 
lid should be everted. This may be easily effected by the 
fingers alone. The patient is told to look down, the 
edge of the upper lid and the lashes are seized by the 
thumb and forefinger of the right hand, and the lid is 
drawn at first forward and then downward away from the 
eye, then upward over the point of the thumb or fore- 
finger of the left hand, which is held stationary on the 
lid and acts as a fulcrum. The foreign body should be 
removed with the handkerchief, but, if it is imbedded, it 
may be necessary for a competent physician to remove it. 

The habit of opening the eyes when dipping the face 
into a basin of water, or when diving, produces congestion 
and inflammation of the conjunctiva. 



214 PERSONAL HYGIENE FOR WOMEN 

Symptoms and Treatment of Conjunctivitis. — The 

eyes may be blood-shot and the lining membranes of the 
lids intensely red. There is a sense of irritation about 
the eyes and an intolerance of light, with a constant sense 
of discomfort. The sensation produced is that of having 
sand in the eyes. The eyes are heavy, and tire after using 
them for a short time. 

The best treatment for acute conjunctivitis, which is 
so often caused by the penetration of dust or other foreign 
bodies into the conjunctival sac, is the application of 
cold water. A folded handkerchief is wrung out of ice- 
water and laid on the closed lids. It must be changed 
every few minutes, so that it shall not become warm; 
two cloths are necessary. When the acute symptoms 
have begun to abate, the patient will no longer find these 
applications grateful, and they must be discontinued. 

For chronic conjunctivitis hot applications are the best. 
For these, one teaspoonful of fine table salt may be dis- 
solved in a pint of hot water, or two teaspoonfuls of boric 
acid may be used instead; the last named is a mild anti- 
septic. The boric acid dissolves very slowly, so that it is 
well to prepare enough in the morning for the entire day. 
One tablespoonful of boric acid may be put into a quart 
bottle of hot water, and be well shaken from time to time, 
until there is a perfect solution. 

When ready for use, half a pint may be heated, poured 
into a tumbler, which is then placed in a basin of hot 
water; this latter serves as a water-bath to keep the 
solution in the glass hot. The application should be made 
with a rather thick wad of absorbent cotton or a piece of 
fine cheese-cloth. The absorbent cotton should be picked 
up with all the water it will hold, and be placed over the 
closed eyes just as hot as can comfortably be borne, and 
held there until it begins to cool, when the procedure 
should be repeated. The two eyes can be treated simul- 
taneously. These hot fomentations should be kept up 
for ten minutes, and be repeated four times a day. 

Trachoma. — This malady, of which so much is heard 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 215 

now, is another name for granular conjunctivitis or 
granular lids. The affection is very contagious. It 
comes on slowly, and is frequently accompanied by redness 
and an appreciable degree of secretion in the early stages. 
Presence of secretion or of interference of the vision 
should always attract attention. 

Strict precautions must be taken that the patient's 
handkerchief, towel, and wash-basin are not used by other 
members of the family. Further, the other members of 
the family should bathe their eyes several times a day with 
a solution of boric acid. 

Styes. — Styes are a very painful species of small boils 
that generally form on the edges of the eyelids. They are 
apt to appear in succession. Certain persons are liable 
to them if the system is run down from general causes. 
Like boils in other parts of the body, they give evidence 
of impaired nutrition. 

Hot fomentations of boric acid solution will some- 
times abort them if used early. If pus has. formed, 
the stye must be opened by an incision parallel to the edge 
of the lid. This should not be attempted by any one 
except a physician. 

Color-blindness. — As a rule, about 4 per cent, of males 
and about one-half of 1 per cent, of females are color-blind. 
The part of the color sense that is most often deficient 
is that for green and red. 

Cataract. — This is a disease in which the crystalline 
lens or its capsule, or both, lose their transparency and 
become opaque. Eventually total blindness is the result. 
Senile cataracts appear after the forty-eighth year. The 
only remedy for the disease is the surgeon's knife. 

Functional Nervous Disorders. — Evidences of sound 
health are: first, individual adaptability or capacity of 
the individual to easily adapt herself to extremely oppo- 
site conditions of existence; second, endurance, or the 
capacity to do a considerable amount of mental work for 
a short time without suffering fatigue, or to be able to 
quickly recover from the fatigue; third, to be able to 



216 PERSONAL HYGIENE FOR WOMEN 

control the emotions; fourth, to be able to resist morbific 
influence; that is, the capacity on the part of sound 
organs of excretion to quickly eliminate all poisons from 
the system. 

The signs of debility are just the reverse: first, de- 
formity, obesity, or leanness; second, personal inadapta- 
bility, that is, when physical or mental discomfort is 
caused by such slight provocations as change of food, 
clothing, or climate; third, lack of endurance, so that a 
long rest is required to repair the fatigue incident to 
slight exertion; fourth, lack of control of the emotions; 
fifth, a proclivity to morbific influences, so that the 
individual succumbs to every contagion or miasm that 
she encounters. 

Nervousness is a disease of civilization, coupled with 
overwork and indoor fife. The more complex the environ- 
ment in which the individual finds herself, and to which 
she must adjust herself, the greater the demands made on 
the nervous system. 

The extreme dryness of our climate, together with the 
great variations of temperature between winter and sum- 
mer and the rapid fluctuations of temperature, predisposes 
to nervous disorders. 

Headache. — Headache is a symptom rather than a 
disease, but there is no symptom which requires more 
careful investigation of its cause than that of headache. 
It occurs at all ages, but is most common from ten to 
twenty-five years and from thirty-five to forty-five years. 
Women suffer from headache more than men, in the 
proportion of about three to one. Headaches are most 
common in the spring and fall of the year and in the 
temperate climates. 

Causes of Headache. — These may be classified into those 
in which the blood is at fault; reflex causes; various 
nervous disorders; and organic diseases. 

The blood may be impoverished, as in the case of anemia, 
where there is a deficiency in hemoglobin; but by far the 
most frequent cause of headache is where the blood is 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 217 

disordered, as in gout, rheumatism, kidney diseases, 
diabetes, and the infectious fevers and malaria. 

Among the more common reflex causes are eye-strain, 
especially errors of refraction; disorders of digestion, 
particularly constipation; and pelvic disorders, as in 
inflammation of the pelvic viscera. 

Functional diseases of the nervous system causing head- 
ache are overwork, neurasthenia, hysteria, epilepsy, and 
neuritis. 

Among the most common of the organic diseases is 
arteriosclerosis; other diseases are meningitis and brain 
tumors. 

Symptoms. — The pain is often dull in character and 
rendered worse by stooping; the location of the pain 
depends on the cause of the headache. The most common 
variety is over the forehead or eyes. In eye-strain the 
pain may either be in the front or back of the head. 
In indigestion, the pain is most frequently over the eyes, 
but it may also be on the top of the head. In anemia 
the pain may be either frontal or diffuse. In pelvic dis- 
orders the pain is generally at the base of the brain, 
though it is sometimes in the top of the head. 

Neuralgic headaches are generally characterized by 
sharp paroxysmal attacks, located in the temporal regions, 
and associated with pain in other parts of the body. It 
is perhaps most frequently caused by anemia. 

In hysteria the headaches are characterized by a 
circumscribed pain — it has been likened to the driving 
of a nail into the head. 

In migraine the pain is paroxysmal and intensely 
severe; it is frequently caused by some poison in the 
blood, as in autointoxication, due to failure of proper 
regulation of the bowels, also by pelvic disorders. 

Treatment. — The treatment is constitutional, and is 
based on the removal of the cause. First, there should 
be a regulation of the diet, a free evacuation of the bowels, 
and their proper regulation. In every case of headache 
there should be an examination of the urine. Often there 



218 PERSONAL HYGIENE FOR WOMEN 

is some congestion of the kidneys where it is least sus- 
pected. If the headache is persistently made worse by 
reading or sewing, the patient should be referred to a 
competent oculist. An inquiry should always be made 
into the condition of the menstrual function, backache, 
and leukorrhea. Any marked disorders here will neces- 
sitate a gynecologic examination. 

For the immediate relief of migraine, the patient should 
go at once to bed and drink a glass of hot water; some- 
times a cup of hot tea gives great relief. No food should 
be taken for from six to twelve hours, according to the 
severity of the case. The room must be kept dark and 
quiet and the head high. 

A strip of prepared mustard leaf, 5 inches wide by 8 
inches long, should be cut, and a piece of cheese-cloth, 6 
or 8 layers thick, should be folded the same size. The 
cheese-cloth is then wrung out of hot water, and the 
mustard leaf is quickly dipped into the same. The cheese- 
cloth is placed on the back of the neck, between it and 
the mustard leaf. The clothes should be kept dry by 
a folded napkin. In this way the mustard may be kept 
on from six to eight minutes, until it begins to burn 
and the skin get red. If left on too long, the mustard 
may produce the most painful kind of a blister. When 
taken off the neck, the mustard may be put on over the 
stomach. 

The medicinal treatment must be directed by the physi- 
cian, but a perfectly safe prescription, and one which may 
be kept on hand, is the following: Take of sodium bromid, 
15 grains; of essence of peppermint, 10 drops; and of 
water a sufficient quantity to make 1 dram. Mix well. 
The dose may be repeated in three hours if necessary. 
This prescription should be put up by a good druggist, in 
a three-ounce quantity. Sometimes relief is afforded by 
1 teaspoonful of the aromatic spirits of ammonia, taken 
in four tablespoonfuls of water, and this is about the right 
quantity of water to take any liquid medicine in. At 
night 2 grains of calomel should be taken, so that the 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 219' 

patient shall not be disturbed through the night, and it is 
not so apt to cause nausea as when taken through the 
day. 

Neurasthenia or Nervous Prostration. — This disease 
first saw light in the United States, and was christened by- 
Beard as an American disease that was absent from no 
household in which the inhabitants used their brains. 
It is certainly much more prevalent in this than in any 
other country. Americans scarcely treat their bodies 
with more consideration than their automobiles; they put 
on high pressure and speed them to the utmost. Add to 
the high pressure under which we live that other fact of 
heredity, that many persons are born with unstable nerve- 
cells, and may be nervously bankrupt, and it is not difficult 
to understand that 50 per cent, of Americans are suffering 
in some degree from lowered nerve tone. 

Causes of Neurasthenia. — All classes of men and women 
who use their brains severely, and who have seasons of 
excessive anxiety and responsibility, are subject to 
neurasthenia. We have seen that fatigue was caused 
by the accumulations of toxins in the body, due to muscular 
activity, but these toxins may also be caused by intel- 
lectual overwork or anxiety over domestic or business 
affairs. 

Other causes are the intemperate amount of intellectual 
work which is forced on the brain, and the excessive 
indulgence of the emotions and the passions. Combined 
with the strenuousness of life is the large element of 
uncertainty, the intense anxiety, and the restless en- 
ergy which is the price of success. Added to these may 
be lack of suitable and sufficient recreation and short 
hours of restless sleep; the restrictions of a narrow lot, 
loneliness, and isolation, the frequent repetitions of un- 
interesting tasks, added to the burdens of maternity, 
domestic cares, and worries. 

In cities the ear-strain caused by the incessant noises 
of the street, the amount of work done by insufficient 
and improper lighting, the unsanitary mode of life, the 



220 PERSONAL HYGIENE FOR WOMEN 

improper diet, the monotonous and infertile work, the 
unhappiness and discontent bred of a life of idleness, or 
one given to society and gambling, whether bridge whist 
or poker, the senseless bolstering of shattered nerves with 
alcoholic stimulants and beverages, patent medicines, and 
hypnotics, all add their quota to the breaking down of the 
nervous system. 

A man can do a prodigious amount of work if he only 
varies it with play which really amuses him, or if he sub- 
stitutes for mental occupation those which involve 
bodily exercises. 

In so-called latent gout insomnia is a frequent symp- 
tom, or insomnia may develop as the result of bad nervous 
habits. Insomnia from whatever cause is followed by 
the impairment of nerve substance and an overloading 
of the body with toxins. This continued nerve exhaus- 
tion leads to oxaluria, uric acid, gout, anemia, gastric 
and intestinal dyspepsia, muscular insufficiency, and 
precordial distress. 

Whatever enfeebles the body by overtaxing the nervous 
system the waste is in excess of the repair, in all over- 
work the destructive metamorphosis is greater than the 
reparative processes, and so there is an accumulation of 
toxic products and a more or less severe and permanent 
injury is done the nervous system. 

Other causes of neurasthenia, not so generally recog- 
nized as overwork, are to be found in the pathologic con- 
ditions of the intestinal canal, which becomes a veritable 
culture tube, and absorption from this into the blood con- 
stantly takes place. And this condition of putrefaction 
has to be overcome before relief can be afforded, and in 
many cases this condition is associated with an insuffi- 
ciency of the elimination of urine. 

The large intestine is the seat of an enormous bacterio- 
logic flora; they are not there by millions, but by billions. 
Some of them are harmless, but not all of them, and if 
these pathogenic bacteria are present in sufficient quan- 
tity, they, too, may produce symptoms of mild poisoning. 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 221 

So, too, may mere indigestion, or the malfunction of any 
other organ, torpidity of the liver, a deficiency of the ex- 
cretion of bile, which is generally accompanied by con- 
stipation. 

The Symptoms of Neurasthenia. — The symptoms are 
essentially those of chronic fatigue, which has become ex- 
aggerated and pathologic. They may be classified as 
sensory, motor, psychic, and somatic. The sensory 
symptoms first noticed are those of generalized fatigue, 
with such localized sensations as headache, backache, 
and limbache. The motor symptoms are muscular fa- 
tigue, muscular weakness, and muscular exhaustion on 
slight exertion. The psychic symptoms are manifested 
by a diminution in the capacity for sustained mental 
effort and the spontaneity of thought and exhaustion after 
slight mental effort. The somatic symptoms show them- 
selves in atony of the digestive tract and the circulatory 
apparatus, with disturbances of the secretions. 

Headache is one of the most common symptoms of 
localized fatigue, and, associated with this, may be a 
sense of constriction about the head, and there may be 
either a sense of lightness or fulness of the head. 

A woman who is chronically tired loses all her personal 
vigor, force, aggressiveness, and, above all, will power. 
Associated with this lack of will power are hesitation, in- 
decision, a marked irritability, and timidity. Neuras- 
thenic patients are subject to spontaneous attacks of 
fear, causeless in origin, and generalized in character. 
These attacks may be accompanied by pallor of the face 
and palpitation of the heart, just as in normal fear. The 
tired woman is a cross woman. The irritability shows 
marked impairment of the power of inhibition. 

The Rational Treatment of Neurasthenia. — First of all, 
there must be a removal of the cause which has produced 
it. There are two distinct classes of cases — the over- 
worked and the idle. The first class, and the most im- 
portant to the world, are the overworked. We may have 
to deal with the intellectually overworked, in which the 



222 PERSONAL HYGIENE FOR WOMEN 

mental overwork was combined with financial anxieties, 
domestic difficulties, or lack of success in their work, or 
the cause may have been the tremendous responsibilities 
of their positions, which involved the lives or fortunes of 
many people. Added to this great strain and overwork, 
has been a lack of proper intervals for rest, recreation, 
and sleep, and the body has become a storehouse for vari- 
ous toxins, and so is suffering from both acute and chronic 
poisoning. 

This class of patients must have the most rigid rest 
treatment, such as was prescribed by Weir Mitchell years 
ago. It is most important that the patient should be 
removed from her old surroundings; if this is not possible, 
she should be isolated on the top floor of the house with a 
good nurse. The room selected must be bright and cheer- 
ful, with plenty of sunshine and fresh air; a window should 
be open practically all the time, for oxygen and sunshine 
are two of the best restoratives. The diet must be easily 
digested and very nutritious. The patient should be 
urged not to use her mind at all. Carefully selected short 
stories may be read aloud by the nurse; the reading should 
not be continued for more than half an hour at a time. 

A great deal may be done to eliminate these toxins from 
the system by the proper use of electric-light baths, fol- 
lowed by the shampoo and the percussion douche; mass- 
age with salt water, salt rubs, and electricity. 

In most cases a month of this absolute rest is as long as 
is beneficial to the patient. And for most of them the 
seashore is the best. There should be enough going on to 
be diverting without being overtaxing, and a climate 
should be selected which is warm enough for the patient 
to live out-of-doors. There should be short walks, drives, 
sails, etc., and this outdoor life, with a contemplation of 
nature, is the most powerful restorative. The grandeur 
of nature, whether it is the mighty forests, with their re- 
freshing shade and quiet, or even stretched in a hammock 
watching the sky and trees, or the constant surging of the 
vast sea, bringing rest in its unceasing restlessness, with 



NERVOUS SYSTEM BALANCE OF POWER IN BODY 223 

the ships sailing lazily along, until the whole fades away 
in the distant horizon. In the vastness of the universe, the 
ego becomes contemptibly unimportant and insignificant. 

After several months spent in this way the body has 
gotten rid of its toxins, nerves and muscles are rested, and 
through the soothing influence of nature the neurasthenic 
is gradually trained back to a healthier habit of thought 
and a more rational frame of mind. There is substituted 
for the morbid emotional complex a feeling of pleasure 
and energy. Reason and judgment reassert their sway; 
outdoor life quickens the perceptions, and forms tranquil- 
izing memory pictures on the brain that return later to 
solace and refresh the individual. 

There is another, and a very large class, of cases among 
women of leisure who have suffered all their lives from 
a lack of a vocation; they have nothing to think of except 
themselves. They do not know what it is to be quite well; 
they travel from one part of the country to another, and 
from one country to another, but they never rise above a 
certain level of invalidism. They are self centered, and 
what they need is the work cure. In the majority of 
cases, before these patients can be restored to health, 
powerful habits must be eradicated, new interests in 
others must be supplied to supplant the most intense egot- 
ism, new paths must be hewn out in the brain, the will 
must be recreated, and character can only be imparted by 
those who possess it. 



CHAPTER VII 

THE HYGIENE OF THE MIND AND ITS RELATION 
TO THE PHYSICAL HEALTH 

Heredity; Temperament; Social Instincts; Fear. 

Mental Development; Self-control, the Moral Sense, the Religious 
Instincts; the Advantages of College Life; Balance of the Mental 
Faculties; the Effects of the Higher Education of Women. 

The Environment; the Choice of Friends; Literature. 

The Power of the Will or Inhibition; the Effect of the Mental 
Attitude on the Physical Health; A Definite Occupation a Physical 
Necessity; the Psychology of Success. 

The solidarity of brain and mind is an axiom of modern 
medicine, and it is a fundamental principle that must be 
kept constantly in view in all physical and mental training. 
Hitherto unsoundness, inefficiency, and weakness of mind 
have only been lightly touched upon in preventive medi- 
cine, but the importance of the mind as the chief factor in 
health and disease is so paramount that it can no longer be 
ignored. 

The problems that present themselves to the mother and 
the educator to-day are practically the same, and the 
mother is one of the most potent educators that we have — 
how the mind can best be strengthened, broadened, and 
be made the most efficient working instrument possible 
through the application of modern scientific and physio- 
logic knowledge. These are questions of vital importance 
to the human race. 

Heredity. — Holmes says: "Each one of us is only the 
footing up of a double column of figures that goes back to 
the first pair. Every unit tells, and some of them are 
plus and some of them are minus. We are mainly nothing 
but the answer to a long sum in addition and subtraction. 

224 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 225 

Slight obliquities are what we most have to do with in 
education." 

There are certain hereditary predispositions that will 
develop under certain conditions; some of them are good, 
some are evil; that is, with the natural development of the 
mind, certain peculiarities of the ancestors will be repro- 
duced. The problems suggested are how the mind can 
best be developed, educated, and trained, so that heredi- 
tary weaknesses may be counteracted or held in abeyance, 
and that latent hereditary talents may be discovered and 
developed. 

The first v proposition that we have to face is that like 
produces like. There are modes of education, of conduct 
in life, and of occupation that should be avoided where a 
boy or girl is handicapped by a bad heredity. There 
are special precautions and attention to physiologic laws 
which would save the minds of many young men and 
women with a bad heredity from passing into a state of 
inefficiency and actual disease. Heredity implies only 
potentiality toward good or evil, and the latter may be 
averted by knowledge and the proper practice. 

Temperament. — This comprises the general make up 
of the individual, the shape of the head, the appearance 
of the eyes, the mobility of the features, the texture of the 
hair and skin, and the kind of movement. The recog- 
nition of the kind of temperament, and a suitable training 
for its best development, is of the greatest importance in 
attaining good health and success in life. 

There are four general types of temperaments — the 
nervous, the phlegmatic, the arthritic, and the scrofulous 
or lymphatic. 

The nervous temperament has certain marked char- 
acteristics, as the small, wiry figure, the well-shaped head, 
the bright, restless eye, nervous bearing, highly strung 
and sensitive nerves, feeling pain keenly and bearing it 
badly. This woman is imaginative, sensitive, fond of 
intellectual work, often artistic and ambitious. In her 
the brain and mind are dominant above all else. When 

15 



226 PERSONAL HYGIENE FOR WOMEN 

run down, this woman will be difficult to bring up again to 
the normal level. She will grow thin, dyspeptic, irritable, 
and often neuralgic. She will be peculiarly liable to ner- 
vous disorders. 

This temperament has its special temptations — alcohol 
and sedative drugs are two of them. Alcohol is not taken 
steadily or for social reasons, but for the effect of alcohol 
on the brain, and there is the greatest danger of becoming 
addicted to alcoholic habits, and finally of becoming an 
uncontrollable dipsomaniac. 

The phlegmatic or bilious temperament relates more to 
the training of the body, since in this class of cases the mind 
is not exposed to the same dangers, but the oversanguine 
temperament has its own dangers, which may lead to lack 
of effort, speculation, and financial ruin. 

The arthritic have a predisposition to both rheumatism 
and gouty disorders, to which they are distinctly more 
liable than others, and the fact that there is this latent 
tendency should be taken into consideration during child- 
hood and youth. 

Social Instincts .—Social instincts lie at the foundation 
on which the family and community is based. It may 
be said that any individual who is destitute of them is in 
an abnormal condition, hence a right training of the social 
instincts is, beyond doubt, one of the most important means 
of securing happiness to the individual and order to society. 
The child's or youth's relation to others, her affection for 
others, and her altruistic practices, all go for the making 
of society, good citizenship, and patriotism in the race. 

At the school age the social instincts are one of the 
strongest elements in life, and one of the most powerful 
adjuncts in developing mind and body. The cravings of 
young women for social amenities are stronger, and her 
deprivation of them more hurtful, than in the case of 
young men. There are few girls in whom it does not re- 
quire some regulation. The strain of too much social 
life is injurious; social dissipation cannot be combined 
with school life without wrecking the health of the young 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 227 

woman; nervousness, anemia, and mental depression 
follow. 

That individual cannot be said to be healthy mentally 
whose social instincts are poor and perverted. Commonly 
one of the first symptoms of a disordered mind is the dimi- 
nution of the social instinct. The insane are notoriously 
asocial. 

Fear. — This is one of the most elemental and primitive 
of the emotions. Biologists assure us that fear and sur- 
prise were the first of the emotions to be developed, and 
that the feeling of the ludicrous was the last. Darwin 
says that the earthworm knows fear, and darts into its 
burrow like a rabbit when alarmed. So we see that fear 
is common to all forms of animal existence, even to the 
lowest. This universality of fear has come about through 
the working of the laws of natural selection, which pre- 
scribe that only those creatures shall survive that can 
best adjust themselves to their environment. Within 
limits, fear as a primary instinct has been and is eminently 
useful. It is the cry of alarm raised by the senses which 
act as guardians of the body, and, at a signal, in virtue of 
the nervous automatism, the organism is put in a position 
of defense. On the other hand, fear may serve to paralyze, 
as has been observed in the case of birds, many of which, 
though scarcely wounded by the small shot, fall to the 
ground as if struck by lightning, panting with wide-open 
eyes. In human life, while fear incites to activity, it may 
also paralyze that activity. 

Mosso says that the fear that young children have of 
cats and dogs, before they have learned why they are to 
be feared, is a consequence of heredity. We are born to a 
heritage of fear. If we fear ghosts and demons less, we 
fear microbes and bacteria more. The professional or 
business man fears failure, but fear should be a guardian, 
not a jailer. A healthy fear of indigence will lead to thrift, 
industry, and such measures as will secure one's personal 
independence. Up to a certain point, fear is a protection, 
but beyond that it paralyzes. 



228 PERSONAL HYGIENE FOR WOMEN 

Mental Development. — We note that at birth the 
brain is mindless, and that the brain-cells, which are the 
vehicle of the mind, undergo their greatest development 
during childhood from stimuli coming from without the 
body. The brain-cells possess infinite possibilities and 
potentialities. They are developed from the stimuli from 
without through the eyes, ears, touch, taste, and smell. 
There is another series of constant impressions which are 
received from within the body, and these come from the 
muscles. 

These impressions, conveyed to the brain-cells from the 
body, and from the outer world beyond the body, leave 
a fixed registration, the writing on the brain-cells has 
begun, and this constitutes memory; and the imprint on 
these cells is similar to that which type leaves of letters 
and words on the page of the printed book. These printed 
impressions on the cells can be revived and seen and heard 
by the mental consciousness, just as a printed book can be 
opened and seen and read by its owner. 

The natural qualities of the mind are imitation, acquisit- 
iveness, emotionalism, and imagination. 

The force of example in the home, at school, and in the 
book world is among the most potent influences in 
molding character. The young girl instinctively imi- 
tates her mother, her friends in real life, and in her book 
world, and the woman will be the composite production, 
combining traits of all of these, which will be ingrafted on 
the ancestral traits which have been inherited. 

In young children it is difficult to decide where the 
imagination leaves off and the spirit of untruthfulness 
begins. In any case, the tendency to exaggeration and 
untruthfulness are so prevalent in childhood that it must 
be checked at the earliest signs of its appearance. The 
vice becomes so deep rooted that it affects the mind in all 
its workings and the entire life as well. It follows men and 
women into their business careers, their scientific life, and 
their professions. 

Professor Swift, in a very interesting study of the devel- 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 229 

opment of the mind, invokes the aid of biology to show that 
all children are but little animals, having no inborn notions 
of right and wrong, inheriting no sense of justice; savage, 
by nature, and predatory by instinct. 

He finds a psychic justification for fighting among 
boys. "Fighting in some form," he says, "is one of the 
first means by which the mind becomes accustomed to 
intense action. To fight well, a boy must be capable of 
severe concentration of attention." 

And he has found the age at which boys come to think 
that laws and the recognized rules of right conduct should 
be voluntarily respected varies from fifteen to seventeen 
years and older. These figures are approximately correct 
for girls. 

Absolute truthfulness, square dealing, honesty, honor, 
and an esprit de corps should be demanded. Hitherto 
these principles have not been sufficiently inculcated in 
girls as the fundamental principles on which life must be 
met. The discipline has been too lax in the home and in 
the school ; it is that of implicit and prompt obedience on 
the word of command; the proper subjection to and res- 
pect for those placed in authority; the kind of discipline 
given in business life, the hospital, and the army, and the 
lack of which has cost so much happiness and so many 
thousands of lives. 

Self-control. — The perfect capacity for self-control in 
all directions and at all times is the ideal state at which we 
aim. It is the standard aimed at by developing the power 
of the will and the strength of inhibition. The great diffi- 
culties, the magnitude of the task, may be conceived of 
from the saying of the wisest of all men : " He who conquers 
his own spirit is greater than he who taketh a city." The 
reason is plainly evident — all the hardest battles of life 
must be fought out alone, there is a feeling of isolation, as 
if one were struggling alone against the combined forces 
of the universe, and, at the same time, there is going on 
the struggle for the mastery between the two conflicting 
natures, " When I would do good, evil is present with me." 



230 PERSONAL HYGIENE FOR WOMEN 

Whereas, in concerted action there is a feeling of sympathy, 
of reinforcement from outside help, and the pleasant stim- 
ulation of competition. 

If youth were taught that certain enemies were going 
to present themselves on the field, that they come for the 
most part in the first instance single handed, and if grappled 
with one at a time, and the contest between right, and 
perhaps inclination, be then and there fought to a finish, 
each successive time the conflict would be easier and the 
victory more certain ; that in losing such a battle there 
must always be a certain loss of self-respect, a feeling of 
moral weakness, it may be even so slight a fault as the 
exaggeration of facts; while, on the other hand, a victory 
always gives something of the same feeling of exultation 
that one has in any fairly won contest or game. A feeling 
of pleasurable superiority, of having one's self well in hand. 
In the moral habits every gain on the wrong side undoes 
the effects of many conquests on the right. The training 
of the will becomes the most vital of all problems. Noth- 
ing that is learned in youth is really so valuable as the 
power and habit of self-restraint, of self-sacrifice, of ener- 
getic, continuous, and concentrated effort. 

The Moral Sense. — From fifteen to twenty-five years of 
age is the most crucial period of life in regard to the hygiene 
of the mind. It is during this period that the brain 
first exhibits some of its strongest hereditary tendencies. 
While such mental factors in human life as conduct and 
character are being consolidated, as they now are, heredi- 
tary predispositions manifest themselves, telling for good 
or evil, for success or failure. 

The acquisitions then made are critical in the extreme 
and often final. The real love of right, hatred of wrong, 
duty, conscience, religion, become solid and effective in 
forming character. 

The emotional nature instinctively shows a leaning 
toward the opposite sex ; love between the sexes toward the 
close of adolescence is the most intense and most unreason- 
ing of human passions. The sense of right, wrong, and 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 231 

duty become active principles, dominating the character, 
There are yearnings after the ideal, an intense scorn of and 
hatred of evil. The purposes in life are then shaped. 
The impressions and resolutions then formed affect the 
whole tenor of the woman's life, as a rule, more than at 
any other time. 

The capacity to feel pleasure reaches its greatest inten- 
sity. The sex relations are built up on safe and natural 
lines, regulated by family life, social feelings, and the carry- 
ing of the thoughts and the emotions into other channels, 
controlled by certain instinctive natural tendencies, by 
morality and religion. To think and feel properly should 
mean to act rightly as a physiologic corollary. 

Music, literature, and art, imaginative works of all 
sorts, mix themselves up with the sex feeling, so that the 
two help to form the emotional nature. Far-away glimpses 
of poetic feeling, pleasurable altruism, citizenship, and 
patriotism show themselves in the earlier stages and give 
direction to life in the later. The whole period is one of 
immense importance for the health and happiness of the 
remainder of life, and the risks to the body and mind are 
then very great. A fact which is of great importance, and 
which is especially true of adolescence, is that it is possible 
by undue pressure to use up stores of energy that should 
have been spread out over very long periods. Through 
such overexertion in study or in games too heavy a drain 
is made on futurity, and mental disorders at this time are 
by no means infrequent, mental depression being generally 
the first to appear. This is more especially true in the 
descendants of neurotic families. The subjects are troubled 
with neuralgias, insomnias, and there is a pessimistic view 
taken of life. 

The Religious Instincts. — Mobius says, "We reckon the 
downfall of religion as one of the causes of mental and 
nervous diseases. Religion is essentially a comforter. 
It builds for the man, who stands amid the evil and misery 
of the world, another and fairer world. Besides his daily 
careful life, it lets him lead a second and purer life. The 



232 PERSONAL HYGIENE FOR WOMEN 

consciousness of being within the hand of Providence, and 
the confident hope of a future redemption, is a support to 
the believer in his work and care, for which unbelief has 
no compensation. Meditation calms and refreshes him 
like a healing bath. Worship breaks in upon the daily 
drudgery of his days with rest and meeting/ ' The moral- 
ity of a nation suffers most severely through the downfall 
of its religion, as experience has always and everywhere 
proved. 

The religious instinct has a very close relation to the 
emotions, morals, esthetic feelings, to social instinct, and 
to sex. The feelings of reverence and awe, and the con- 
sciousness of the infinite in man are vague, but are the 
most powerful parts of his nature. 

Religion furnishes the only pure ideals that half of the 
world has access to. It has proved an intellectual stimu- 
lus, and roused a metaphysical frame of mind in some of 
the most vigorous nations, such as the German and Scotch. 
It leads more toward refinement of life than any other 
agency. It stimulates the benevolent and altruistic feel- 
ings, and leads to their practical demonstrations; it fights 
vice and immorality; it seizes on the best that is in man 
and transforms the character. 

The Advantages of College Life. — College life is of 
the greatest possible advantage to girls in many ways: 
it is broadening to the mind; discipline is maintained, and, 
at the same time, the girl is thrown on her own resources; 
adequate means are provided for developing both mind and 
body to their greatest capacity. 

Whether the girl comes from the country, a country 
town or city, her social group is comparatively limited; her 
world is very little and the ego is very large. The dis- 
cipline that any large body of students bring to bear 
on the conduct and behavior of the individual is one of 
the important advantages of a college training. The 
insignificance of the ego, who is only a unit in this 
large community, is quickly impressed on the gray matter 
of the brain, and the rough and unpleasant angles are soon 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 233 

smoothed off. This, in addition to the discipline afforded 
by the college officers, and the total lack of discipline is 
the weakest point in the average girl's education. To 
be brought into intimate relation with the members of a 
large and educated community is in itself a liberal educa- 
tion. To learn to respect the rights and the opinions of 
others, to perceive that any given subject has a great num- 
ber of points of view, is attaining toward a healthy mental 
balance that will make the woman broader minded, more 
sympathetic, more companionable, and more charitable 
in her views of life. 

In addition to the regular college curriculum are the 
opportunities afforded, not only to special students, but 
to the entire body of students, for a liberal education in 
music and art, and so a broad foundation for general 
culture is laid that will greatly increase the opportunities 
for pleasure all through life. 

So that, in addition to the actual knowledge acquired 
by a college education, there are also the advantages of 
the discipline of and development of mind and body; the 
knowledge of how and what is worth while to study; the 
power to study and solve life's greatest problems for her- 
self and those dependent on her; the firm muscles, the 
clear brain, the steady nerves, the power of judgment, the 
control of the will, and the formation of character — on all 
of which the ultimate happiness and success in life depend. 

Dr. Beard gives to brain workers a value of life of four- 
teen years above the average. The brain-working classes 
are less apt to worry, less apprehensive of indefinite evils, 
and less disposed to magnify minute trials than those who 
five by the labor of their hands. 

Spinoza says that every advance toward perfection 
gives us happiness, and it is safe to say that the buoyancy 
which characterizes contemporary thought, the hopeful 
outlook amidst the dangers which threaten us, the sense 
of the added cubit to the man's stature, are due largely to 
the recognition of the power for good within his soul of 
which he was not formerly aware. 



234 PERSONAL HYGIENE FOR WOMEN 

Balance of the Mental Faculties. — There must exist a 
certain balance between the various faculties of the brain 
in order to insure sanity. A high order of intelligence 
without much will, or keen emotions without a corres- 
ponding power of inhibition, and overmastering will and 
slight moral sense, vivid imagination without common 
sense, intense social instinct without much conscience, 
fervid religious instinct without much sense of duty or 
altruism, must invariably produce one-sided and unbal- 
anced individuals, and the results would be bad for society; 
and too many of these one-sided or unbalanced people 
would impair if not endanger the safety of the State. 

Excessive ambition, misdirected energy, longing for the 
unattainable, regret for the unalterable, anticipation of 
future unhappiness, lack of a sense of perspective, fretting 
over non-essentials, indecision, reopening of troublesome 
questions already settled, avarice, selfishness, excessive 
emotions, uncontrolled passions, and the actual cultiva- 
tion of the melancholic state are some of the causes of 
mental anguish and subsequent physical suffering. 

Well-balanced mental faculties give a philosophic view 
of life; guard the mental and hold the emotional in check; 
grasp the true relationships in life, and view it in the 
proper perspective. 

The Effect of the Higher Education of Women. — Nothing 
is so convincing as actual experience and statistics; 1 and 
nothing is so broadening to the mind as the study of 
history. 

Never before in the history of the human race has any 
such large body of young women been given the edu- 
cational advantages for the development of body and 
mind which they enjoy to-day. From antiquity there 
have been exceptional women, who were highly educated 
and cultured, as in Alexandria, Athens, and in the old 
European universities, but up to the present day any 
tendency toward the education of the masses of women 

1 " Education as the Controlling Factor in the Physical Life of 
Woman," Four Epochs of Woman's Life. 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 235 

has been looked at askance, and in this respect the position 
of the people of the United States was long peculiarly 
provincial. 

To two men belong the great credit and honor of con- 
ceiving the idea of a liberal college education, and a medi- 
cal college training, for women in this country. 

In 1865 Mathew Vassar, "having recognized in woman 
the same intellectual constitution as in man/' founded a 
college for women only, and thus gave women the oppor- 
tunity for the same education that young men enjoyed at 
their colleges. 

In 1850 the Woman's Medical College of Pennsylvania 
was incorporated. The idea of establishing a college for 
the medical education of women originated with Dr. 
Bartholomew Fussel, of Chester County. The query arose 
in his mind, " Why should women not have the same 
opportunities in life as men?" 

Just how strong the public sentiment was against these 
movements, and the leaders of the opposition comprised 
the most prominent educators and physicians of the day, 
and what impediments they placed in the way, it is now 
difficult to realize. 

The opponents of the higher education of women urged 
three final objections: First, women were mentally in- 
capable of receiving the same kind of intellectual educa- 
tion as was given to young men at college. Second, they 
lacked the physical endurance to bear the strain of mental 
work. And, third, such an education would render the 
young woman masculine — she would no longer be willing 
to look after the ways of her house, her natural affections 
and power to love would vanish, she would become unwil- 
ling to marry and bear children. 

Ex-President Eliot, of Harvard University, who has so 
long been the great educational leader in this country, 
in his paper on "The Higher Education of Women," 
says: "During the past thirty-five years three distinct 
apprehensions concerning the effect of the higher educa- 
tion of women seem to me to have been removed. In the 



236 PERSONAL HYGIENE FOR WOMEN 

first place, there was a perfectly sincere doubt (because 
there was little experience to go upon) whether young 
women were so capable as young men of receiving what 
was then called the higher education; or, in other words, 
whether the young woman had the capacity to master by 
study the traditional subjects of the higher education. 
That doubt has been completely removed. 

"Secondly, it was feared that if the young women 
studied in the colleges three or four years, beginning 
at about eighteen years of age, that such study would 
have serious effect on their health and on their fitness 
for their natural functions in after-life. This apprehen- 
sion was felt by many physicians and was warmly ex- 
pressed. For a whole generation we have been trying 
the experiment, and the result is perfectly clear. These 
apprehensions have not been justified. It is apparent 
that young women can do much mental work for three 
or four years between the age of eighteen and twenty- 
two, not only without impairing their physical vigor, 
but all the time improving it, if they live wisely and under 
right conditions. 

"And thirdly, there was the strong apprehension felt 
by many excellent people, lest in the process of the 
higher education young women would be denatured. 
They admitted that young men were not denatured in 
any way by the higher education at college, but they 
thought that there was a serious chance that young women 
would be altered in their feminine nature by the process 
of education. It has turned out that a young woman 
who studies in college, from the age of eighteen to twenty- 
two, is no more altered in her nature than a young man is 
who goes through a similar process. It takes a great deal 
more than that to alter the nature of a woman. 

"I suppose that this apprehension was based on the 
fact that women seem, to men at least, more tender, 
fragile, and delicate than men, and, therefore, more liable 
to be bruised or coarsened than men; it was feared that 
the kind of public life, so to speak, in large groups would 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 237 

have some tendency to deprive them of their natural 
delicacy, refinement, and tenderness. It has not turned 
out so, and everybody recognizes that it has not turned 
out so." 

When higher education, the professions, and industrial 
pursuits are all unquestioningly thrown open to women, 
then it can be reasonably supposed that they will come 
to possess those traits of mind — judicial, logical, creative, 
etc., now generally considered as masculine traits, and 
they will not only be more attractive and companionable 
for their husbands, but will be far more competent 
teachers for their children, their enlarged range of thought 
and vision inspiring greater confidence in their sons, 
and stimulating higher ideals in both sons and daughters. 

The Environment. — As we have seen, the brain 
registers every impression from within and from without; 
if the impressions are those of discomfort, gloom, darkness, 
ugliness, those things, being inharmonious to the con- 
stitutional working of the brain, do harm and tend to set 
up bad habits. First, the body must be healthy, and 
the environment good in order to insure a healthy, vigorous 
mentality. Too much thought and care cannot be given 
to the environment of the child, youth, and adult. 

Careful attention must be given to the toilet. The 
quality and condition of the underlinen, the cut and fit 
of the clothes, all tell on the mind. It has been said that 
a man tries to live up to his clothes; hence, the uniform 
of the soldier and the cassock of the priest. Clothes are 
not only an index of the character, but they help to make 
it. The clothing that comes into intimate contact with 
our bodies has a soothing or irritating effect upon the 
mind. It has also been said that for a woman to know 
that she was properly dressed had a soothing influence 
on the mind, second only to that of religion itself. 

In the evening, laying aside the business suit of the 
day with all the anxieties and dust of toil, and replacing 
it by a tasteful house-gown, brings a sense of freshness 
that brightens the mind and stimulates the appetite. 



238 PERSONAL HYGIENE FOR WOMEN 

The clothing should always be suitable to the employment, 
to the purse, and to the surroundings, or good taste is 
violated, and, again there is an unhealthy reaction on the 
mind. 

To live in a gloomy house, with a dull ugly wall-papers, 
and no sunshine entering the room, may produce in their 
inhabitants want of appetite, interfere with nutrition, 
make them gloomy, unhappy, and hard to live with. 
While esthetic surroundings render life happier, brighter, 
and higher. 

If one cannot afford expensive paintings to hang on her 
walls, she can select photographs of the old masters, 
neatly framed, which, placed in harmonious surroundings, 
elevate the mind, cause a love of the beautiful, develop 
the taste, and lay the foundation for a broad culture 
that will increase the enjoyment of nature as well as of 
art. 

The Choice of Friends. — We have seen that the impres- 
sions conveyed to the brain-cells leave a fixed registration 
and are indelibly stamped there. These may be called 
the sensitive plates of the mind, and it is because of this 
writing on the brain that the selection of our friends and 
associates is a matter of such vital importance. 

The subconscious mind, of which we hear so much to- 
day, does not originate thought; it can only elaborate 
and develop it, and the most important fact which has 
as yet been discovered in regard to the subconscious mind 
is that it is suggestible; that is, it is subject to moral 
influence and direction. A few words of commendation 
and praise brighten the whole day; if we can forget our 
pain for a little while, it is apt to cease. 

All our greatest intellectual leaders, from time immem- 
orial, have been unanimous in their teachings that one 
of the most important elements in the molding of the 
mind and character was the nature of our friendships. 
Tennyson says, " I am a part of all that I have met." "A 
man's friendships shape his life more than aught else, or 
more than all else." The immortal bard puts it, "It 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 239 

is certain that either wise bearing or ignorant carriage is 
caught, as men take disease of one another; therefore, 
let men take heed of their company." And again, " 'T is 
meet that noble minds keep ever with their like, for who 
so firm that cannot be seduced?" 

Certain requirements and standards should be met, 
and the girl or woman should be sure that the individual, 
whether man or woman, comes up to the standards of 
her own clan. 

A friend should be congenial, with similar tastes, oppor- 
tunities, and training; frank in criticism, yet sympathetic 
in spirit; loyal and staunch in adversity, and one who 
disseminates an atmosphere which is broadening, elevat- 
ing, and uplifting. Such a friend is to be desired and to 
be sought after. 

Literature. — Not one of the least of the great molding 
influences on the mind and the social life of to-day is its 
literature, and the form of this which reaches the greatest 
masses of the people are the daily press, the literary 
magazines, and the modern novel. It is scarcely pos- 
sible for the young to conceive the great impression 
which is made on the mind and character by the kind 
of books which they read. Carlyle said, " We cannot 
look however imperfectly upon a great man without 
gaining something from him." And to this statement 
might well be added, it is impossible for the mind to be 
brought into intimate contact with the lives of dissolute 
men and women, so vividly portrayed in many of the 
novels of the day, without being smirched by it. It is 
no more safe to read such a class of books, hoping to 
escape contamination, than it would be to live in the 
malarial districts of Africa, and hope to escape contracting 
that insidious disease. 

However limited the geniuses may be in our immediate 
circle of friends, each of us may have for her most intimate 
friends the greatest geniuses the world has ever known, 
and have them at their best. 

Two axioms should always be kept in mind — a real love 



240 PERSONAL HYGIENE FOR WOMEN 

for books is formed in early life or not at all, and to have 
books for friends one must own them, have them on her 
own shelves, to take down and put up at will, to mark, to 
compare, and study. So whatever else one lacks, she 
should always have her own library, even if it is a limited 
one. 

Next in importance to the recognition of good reading 
must necessarily be a recognition of the limitations of one's 
reading. Whether in the capacity of student, housewife, 
mother, or business woman, the time that can be devoted 
to general literature is very limited. 

A careful study of history and biography should always 
precede fiction. It is a fundamental part of a liberal edu- 
cation to know something of the world's history, and the 
history of the English nation, as well as the biographies of 
the men and women who were such important factors in 
making its various epochs. 

This should be followed by a study of the classics, and 
that education has not been liberal which has not included 
a study of the modern classics. German literature opens 
up a new and delightful world. A study of the classics 
forms the taste, elevates the mind, broadens the vision and 
the power of judgment, and it is a profound help in the 
formation of character. After such reading as this, who 
would be willing to spend her time on the cheap and trashy 
novels of the day. 

Good modern fiction should be taken up as a recreation 
by the woman whose life is laborious, its questions per- 
plexing, and its complications tiresome; in other words, 
after the woman has left the high-school or college and has 
entered on her life's vocation. For young girls, not only 
is too much time apt to be given to fiction which should be 
devoted to other and more important matters, but it is 
apt to do much harm by giving them a wrong impression 
of life. 

The Power of the Will or Inhibition. — The conduct of 
mankind is chiefly governed by the emotions, instincts, 
and impulses. Spencer traces all human action to the 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 241 

desire for pleasure in the large and philosophic sense of the 
term. If this be so, then the education and hygiene of the 
emotions and impulses must be of the very highest im- 
portance in the life of each individual and in the social 
world. The question arises, and it is all important, can 
those inhibitory centers be so developed in youth, and so 
cultivated in life, that they can act as antagonists to what 
is morbid? Can they be used as direct preventive and 
curative agencies against tendencies and impulses which 
are foolish and hurtful? And the answer of educators, as 
the result of large experience and observation, is emphatic- 
ally, yes. 

But the training, to be efficient, has to be systematic, 
persistent, and along well-defined lines. The first step 
in this training must be the strict avoidance of all that has 
a tendency to lower the standards of morality, whether 
this is in the line of companions, literature, the stage, music, 
or art. To do otherwise is not brave, but as foolhardy 
as it would be for a weak army to advance against a power- 
fid foe; it means annihilation or to be taken prisoners 
of war. 

To overcome obsessions and delusional beliefs by vo- 
litional effort, the effort should be made to direct the 
mind to other subjects which have nothing whatever to 
do with the obsession, rather than to make a direct stand 
of the will against it, since the will may put forth its ut- 
most strength in the way of direct repression of the 
temptation to any immoral action, and may entirely fail, 
while, by directing the same amount of force in chang- 
ing the direction of thought, complete success may be 
attained. 

The influence of the will upon the emotions is a matter 
of the highest importance in regard to the direction of the 
current of thought and the determination of actions. 
Control your passions; govern your temper. We can no 
more avoid feeling mentally hurt than we can feeling phy- 
sical hurt, but we have exactly the same power of the with- 
drawal of the attention from the mental hurt as from the 

16 



242' PERSONAL HYGIENE FOR WOMEN 

bodily pain, by determinately fixing it upon some other 
object. 

"I am, I ought, I can, I will," are, as has been well 
said, the only firm foundation-stones upon which we can 
base our attempts to climb into a higher sphere of exist- 
ence. The first implies a faculty of introspection, the 
second a moral judgment, the third a consciousness of 
freedom to act, the fourth a determination to exercise that 
power. 

The influence of the will on the conduct is first auto- 
matic, through previously acquired habits; second, through 
the emotional state, and third, by our notions of right and 
wrong. In the fundamental principles of living must be 
included a genuine consideration of the right of others. 
The memory is an automatic reproduction of ideas, the 
mechanism of recording processes. 

The education of the will, the power of breasting the 
current of the desires, and doing for long periods of time 
what is distasteful and painful, all tend to increase the 
power of inhibition and strength of the will. Nothing 
that is learned in youth is really so valuable as the power 
and habit of self-restraint, of self-sacrifice, of energetic, 
continuous, and concentrated effort. 

Seneca claims that difficulties strengthen the mind 
as labor does the body. Plato said, that "self-conquest 
is the greatest of all the victories." 

Character lies preeminently in the sphere of the will, and 
anything which weakens the will saps the worth of life at 
all points. The strength of will bears not only on char- 
acter, but on happiness and influence as well. The leader 
must show reserved power, and make it plain that she has 
herself well in hand, to secure confidence. " Will makes 
men giants." 

The Effect of Mental Attitude on the Physical 
Health. — The ordinary operations of the mind have little 
effect on the physical condition, but such emotions as fear, 
worry, anxiety, grief, despair, anger, hatred, and the like 
depressing emotions act directly upon the muscular and 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 243 

nervous mechanisms, profoundly affecting the seeretions 
and the excretions, and stamp themselves upon the very 
tissues of the organism. 

Of all the mental attributes the emotions are the most 
exhausting. A woman can spend more of her strength in 
five minutes of unnatural excitement than in a day of calm, 
steady brain work. 

A perfect temper is not only a prime requisite for a club 
president, but for every man and woman in this hard 
workaday world, with its fierce competitions, its petty 
jealousies, and the stiletto practices of the cowardly, 
and it is one of the greatest preventives of indigestion, 
insomnia, and nervous prostration. 

Forget your grievances. Every time that one repeats 
them to herself or to a friend she lives them over again, 
and the original trouble was but the merest moiety of 
suffering compared to a wound torn open afresh every day. 
To cherish a vindictive spirit does a vast amount of injury 
to the possessor of that spirit. In view of the facts of 
the beneficial effects of fighting upon small boys, and that 
the combative propensities of the Irish peasant commonly 
evaporates with his shillelagh, it would seem commendable 
to introduce boxing matches among women as a way to 
settle their differences. 

From the standpoint of health, the intense excitement 
attendant on playing for high stakes, the loss of sleep, the 
unnatural life, the loss of money that one can ill afford to 
lose, must eventually lead to a serious if not to a fatal 
breakdown. 

It is not the natural and reasonable intellectual work 
that injures the brain, but the various emotions — ambi- 
tion, anxiety, disappointment, the hopes and fears, the 
loves and hatreds of our fives — that w T ear out the nervous 
system and endanger the balance of the brain. 

Powerful emotion is like concentration attended with 
dissociation, it occupies the mind to the exclusion of all 
else, even to the dictates of self-preservation and reason. 



244' PERSONAL HYGIENE FOR WOMEN 

The will is more or less suspended and held in abeyance 
during the emotional states. 

The too great concentration of the attention on one's 
business or occupation is a self-indulgence that often 
ignores the importance of the lighter side of life and the 
legitimate claims of family and friends. 

Less ambition and more philosophy would greatly 
lessen the number of cases of nervous prostration and 
allied neuroses. All of one's fortune is not staked on one 
throw of the dice; if the woman fails in one direction, there 
are other resources left. 

Concentration of the mind on the physical suffering 
leads to the so-called habits in disease; there may have, 
in the first place, been a real physical cause. For example, 
in case of injury to a limb followed by severe pain in that 
member it has happened that after amputation of the 
limb the consciousness of pain persisted in the brain. 
In the functional neuroses, the first cause may have been 
a real physical one, but the individual becomes so self- 
centered, it is with difficulty that the mind can be with- 
drawn from the ego, and a cure can only be effected by 
supplanting the intense egotism by new interests. 

Medical literature contains numerous observations of 
ailment caused by fright, and even of death itself so 
caused. It is not uncommon for medical students to con- 
tract the disease about which they are studying. In the 
old small-pox epidemics it was a very generally observed 
fact that those who feared contracting the disease were 
the most apt to get it. The reason is very easily explained 
— fear so suppressed the functional activities of circulation 
and nutrition, as to predispose the individual to take any 
disease to which she was exposed. 

Autosuggestion is the predominant element in the con- 
centration of the thought on one particular subject, and 
of the narrowing of the perspective to a single point of 
view. 

Prolonged anxiety or grief will cause an emaciation, 
second only to that of tuberculosis itself, by the depression 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 245 

of the heart's action and the circulation, the loss of ap- 
petite, the interference with nutrition, and the loss of 
sleep. 

Worry is, as we have seen, in the first instance most 
frequently bred of exhaustion, but, if indulged in, it readily 
becomes a fixed habit, and the mind rapidly settles into a 
state of fixed gloom. 

Worry is a type of fear. It is a futile regret over past 
mistakes and the miserable forecasting of the future. 
It has been called the great shortener of life under civiliza- 
tion — of all forms the financial one is the most frequent 
and, for ordinary minds, the most distressing. 

Anxiety and the anxious frame of mind is in readiness 
to take fright in connection with our most vulnerable 
points on all occasions of apprehension or uncertainty. 
As no one's future can be clear throughout, there is never 
wanting the matter of anxiety to a mind susceptible of 
this state. 

It is a significant fact that our asylums are recruited 
from the classes who spend their fives amid narrow monot- 
onous surroundings; hence the large proportion of women, 
especially of farmers' wives, whose lives are probably the 
most narrow and the most monotonous. From this result 
the fixed ideas, the obsessions, and all the absorbing 
egotism of insanity. 

With a variety of valuable and permanent interests, 
the mind is well safeguarded against attacks of worry. 
The overworked woman should increase her recreations, 
leave home for short intervals, travel, and have entire 
rest and change of scene. With increased vigor of body 
will come increased power of the will and the capacity to 
abolish worry. 

Anger floods the brain with blood, and if the arteries are 
brittle, as they are in old age, and the individual is just 
as old as her arteries, the rise in arterial tension may 
result in the rupture of a blood-vessel, and the subse- 
quent hemorrhage into the brain may cause an attack of 
apoplexy, paralysis, or even death. Attacks of anger 



246 PERSONAL HYGIENE FOR WOMEN 

hasten the deterioration of the arteries; in this way anger 
has been known to cause death. 

Every violent physical sensation will react on the lungs; 
every powerful normal emotion, whatever its cause, will 
also make its influence felt on the respiratory functions. 
An exercise which is performed with tranquil breathing if 
the mind is free from care, quickly produces respiratory 
disturbances if the mind is brooding and preoccupied. 
Those who have acted as seconds in a duel to men accus- 
tomed to the use of the sword know that they become 
breathless in the duel much more quickly than they do in 
the fencing school. 

Depressing emotions make themselves felt in the respir- 
ations of animals as well as of man. A sensitive horse, 
which is badly used at its work, or even roughly spoken to, 
rapidly becomes breathless. 

The dog is incomparably less swift than the hare, but 
is able to catch it ; the fright of the hunted animal disturbs 
its breathing and robs it of much of its strength. 

In fright the disorder of the respiratory movements 
destroys the regularity of the interchange of gases which 
takes place in the lungs, between the venous blood and 
the atmospheric air, and thus profoundly hinders the 
function of the aeration of the blood. 

The more impressionable the subject, the more easily 
do the emotions influence his respiratory actions. Hence, 
the superiority in certain bodily exercises of men whose 
minds are calm and masters of themselves. 

Emotional causes, such as worry, anxiety, and grief, 
as well as the more tangible physical factors, cause soften- 
ing and disease of the tissues, which frequently accounts 
for the arteriosclerosis and premature senility. Alienists 
have long found abundant evidence that abnormal physical 
conditions are capable of producing mental diseases, but 
the reverse is quite as true. 

And not only the imagination, but the intellect, the 
emotions, and the will have or may have a powerful in- 
fluence over the sensations and organic functions. 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 247 

It is not only profoundly true that mental attitude has 
much to do with bodily function, capable of producing 
changes in its nutrition and secretion, but we may go 
further and say that healthful and hopeful habits of 
thought do much to put the body on the defensive against 
the assaults of disease. 

Mental attitude refers not to the will or the emotions, 
but to the mind in its entirety. The trend of a woman's 
thoughts, the use she makes of her intellect, the strength 
of the volition, the sense of responsibility, and the objects 
of her life are all questions that have a distinct bearing 
upon the bodily functions and the health of the individual. 

A Definite Occupation a Physical Necessity. — It is 
now generally conceded by the leading sociologists of the 
day that women who are not engaged in the duties of 
maternity need the same intellectual and industrial ac- 
tivities as men. Many go further, and it is their opinion 
that there is no reason for excluding women, who are ful- 
filing the duties of maternity, from exercising full intel- 
lectual and physical activities in other directions. And 
the proof that this is not a mere theoretic assumption 
is to be found in the fact that many women have not only 
given birth to a family of children, but have successfully 
reared them, and, in addition, have been eminent in other 
pursuits and callings. Well-known illustrations of this 
fact are to be found among the most noted sovereigns that 
Europe has ever had — Catherine de Medici, Maria Theresa, 
Catherine II of Russia, and Queen Victoria. 

Pleasure seeking, as the end and object of life, leads to 
ennui, disgust, and physical and mental deterioration, 
while the slavery of housework, the childish vanities, and 
petty cares and vexations are most injurious to the nervous 
system, so that for the life of the housewife the education 
preceding it should be broad ; and the more highly educated 
the woman is, so much the more effectually can she free 
herself from attaching too much importance to every little 
detail, and so neglecting what is higher and more import- 
ant, and it will be a great preventive of irritability of 



248 PERSONAL HYGIENE FOR WOMEN 

temper, quarrelsomeness, and even melancholia and 
mental derangement, from which so many of these women 
suffer in consequence of the monotony of their lives. 

Every girl when she leaves school, which she should 
consider the very alphabet of her education, should 
prepare herself for some definite occupation, just as her 
brother does. 

Clouston, in answer to the question as to how the 
powers of the mind can best be developed, conserved, 
and made the best use of for life's work, says: "It is a 
most fortunate thing, if, during the later period of ado- 
lescence, an occupation in life has been selected which 
really suits the capacity of the individual and goes with 
his innate tendencies. The seriousness and the settled- 
ness of the life of the period, with the bracing of every 
nerve and sinew to do the work, to gain a reasonable 
position in society, and to enjoy a fair amount of happi- 
ness, is in itself a tonic of no mean value, while over- 
taxing of body and mind is always a risk, as well as an 
ambition which overreaches itself. The repressions of 
woman's life in civilized society constitute one of her 
serious strains and dangers. The life and conditions of 
a working woman who has six or seven children in a few 
years, who has small means, and but little help, is in my 
judgment the very hardest of any human being in our 
modern social system." 

Thomas 1 thus sums up his views as to the evils result- 
ing from the non-occupation of women of the better 
classes. "Human nature was made for action; and 
perhaps the most distressing and disconcerting situation 
which confronts it is to be played on by the stimulations 
without the ability to functionate. The mere super- 
inducing of passivity, as in the extreme case of solitary 
confinement, is sufficient to produce insanity, and the 
emotion of dread or of passive fear is said to be the most 
painful of the emotions, because there is no possibility 
of relief by action. 

1 "Sex and Society." 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 249 

" The American woman of the better class has superior 
rights and no duties, yet she is worrying herself to death; 
not over specific troubles, but because she has lost her 
connection with realities. Many women, more energetic 
and more intelligent than their husbands or brothers, 
have no more serious occupation than to play the house 
cat, with or without ornament. It is a wonder that more 
of them do not lose their minds; that more of them do 
not break with the system entirely, is due solely to the 
inhibitive effect of early habits and suggestions. 

"The remedy for the irregularity, pettiness, ill health, 
and unserviceableness of modern women seems, therefore, 
to lie along educational lines. Not in general and cultural 
lines alone, but in a special and occupational interest and 
practice for women, married or unmarried. This should 
preferably be gainful, though not onerous or incessant. 
Normal life without normal stimulation is impossible, 
and the stimulation best suited to the nervous system is 
some form of interesting work." 

The Psychology of Success. — Success has been defined 
as the accomplishment, the realization of what has been 
willed or wanted, the ripe fruition of the well-tended tree. 
The achievement of fame or fortune is what the world 
generally regards as success. 

Before entering on an enterprise, all the premises in the 
case must be had in order to form correct judgments, 
otherwise incomplete and imperfect knowledge of the 
case will lead to error in judgment, in which there 
could be said to be "no chance of failure, it was a cer- 
tainty." 

An element that always makes for success is to be able 
to supply a want of the public; it is partly a question of 
demand and supply. It is sometimes possible to create 
a demand. But, as a rule, success is the fruition of 
patience and well-directed energy. 

There is nothing which tends so much to the success of 
volitional effort as the confident expectation of its success, 
while nothing is so likely to induce failure as the appre- 



250 PERSONAL HYGIENE FOR WOMEN 

hension of it. Since the tendency of the cheerful and 
joyful emotions is to suggest and keep alive the favorable 
anticipations, while that of the depressing emotions is 
to bring before the view all the chances of failure, the 
former will increase the power of volitional effort and 
the latter will diminish it. 

The mental condition also exerts a direct influence 
upon the physical powers, through the organs of the 
circulation and of the respiration, the heart's impulse being 
more vigorous and regular, the aeration of the blood 
being more efficiently performed, in the former of these 
conditions than in the latter. 

Success too easily won, or won early in life, may really 
be a cause of failure, because, having been once achieved, 
the individual may be content with what she has and 
not proceed to higher development. And so a very 
inferior success may be the tomb of energy and the 
satisfied goal of ambition, instead of a stimulus to higher 
things. 

Lack of success may also be caused by indulgence or 
lack of courage, the individual preferring to sail along 
the chartered course of mediocrity rather than to strike 
out a new path for herself, involving risk, anxiety, and 
endless work. 

And perhaps jealousy in the rank and file of the lazy, in- 
different, and mediocre far more often impedes effectually 
the road to success than is dreamed of, so that a greater 
degree of secretiveness, warding off the scent, of the 
intentions, the aspirations, and the methods of work, until 
the object shall have finally been achieved. 

Another and most important secret of success is to 
recognize failure as only a stepping-stone to higher things. 
Eggleston says, "Persistent people begin their success 
where others end — in failure." 

The people who succeed in this world are the people 
who get up and look around for the circumstances they 
want; if they cannot find them, make them. "Circum- 
stances, " said Napoleon, "I make circumstances." 



HYGIENE OF MIND AND ITS RELATION TO HEALTH 251 

There are four mental requisites necessary to the 
achievement of success, namely: a clear view of the end; 
a judicious indifference to the sentiment around by the 
sweeping away of obstacles; an indomitable energy; 
and the power to resist the temptation to rest on the 
soporific plane of mediocrity. 



CHAPTER VIII 

DRESS THE FUNDAMENTAL CAUSE OF WOMAN'S 
PHYSICAL DETERIORATION 

The History of Woman's Dress; the Corset in History; the 
Crusade Against the Corset; the Influence of the Corset on the Female 
Body; the Curved Front Corset; the Relation of Corsets to Ab- 
dominal and Pelvic Disorders; the Effects of Corsets on the Muscles; 
the Straight Front Corset; the Abdominal Corset; the Wearing of 
Corsets by Young Girls; What Style of Corset is the Least Injurious, 
the Shoe; the Stockings; the Essential Qualities for Winter Under- 
clothing; the Length of the Walking Skirt; the Winter Street Dress. 

A careful study of the history of woman's dress affords 
a forcible demonstration of the fact that the fundamental 
cause of the inferior physique and lowered vitality of 
the modern woman of civilization is to be found in not 
only her own, but also in her female ancestors' unhygienic 
mode of dress for many centuries. 

Study the physique and dress of the ancient Greeks, 
then follow the history of dress down through the Middle 
Ages and the Renaissance to the present time, and, if 
further proof be needed, visit, as has been done, the 
savage races of the earth to-day, and behold women of 
powerful and classic physique still exist in lands where 
the body is not molded according to the barbarous decrees 
of the " modiste of fashion." 

The History of Woman's Dress. — The history of 
Greek costume is for the most part free from what is 
known as change of fashion, for the reason that the Greeks 
did not attempt to reconcile the two opposite principles 
of covering, and at the same time displaying the figure; 
that is to say, of cutting the dress to fit the body. 

The dress of the Greeks, when at the height of their 
civilization — and that of the Assyrians, Egyptians, and 

252 



PLATE II 




e~ d 



L " 





Greek costumes. " Queen and two attendants." 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 253 

ancient Romans was not essentially different — was very- 
simple. It often consisted of a simple garment, the tunic, 
which pleased the eye by the gracefulness of its drapery, 
and at the same time was comfortable by reason of its 
looseness. 

The chief and indispensable article of female dress was 
the chiton, or tunic, consisting of one piece of material, 
sewed together in the form of a sack, open at top and 
bottom, in height reaching from the neck to the feet of 
the wearer, and in width equal to that of the extended 
arms. Within this stands the figure, and first it is girt 
around under the breasts by a girdle, to keep it from 
falling; next the upper edges are fastened together on the 
top of the shoulders by a brooch, and the arms are either 
left bare, pressing down into folds at each side the masses 
of material, or these masses may be gathered around each 
arm, and fastened down the outside with buttons and 
loops, so as to form sleeves. 

To secure greater warmth on the breast and shoulders 
the chiton was made long enough to be doubled back at the 
top, and this part reached to the waist. Underneath the 
chiton was worn a band of cloth, to support the breasts, 
and, in addition to this, a cord was sometimes crossed 
round the breasts outside the chiton, to assist either in 
supporting them or in bringing out their form. Round the 
loins was sometimes worn either a short petticoat of thick 
woolen stuff or a sort of bathing drawers, such as acrobats 
wore. This was all of the essential dress for indoor wear. 
The chiton was made of a variety of fabrics, though gen- 
erally of linen. 

For outdoor wear was the himation, a garment also 
worn by men ; it was made of woolen stuff and was worn 
like a plaid. 

The chiton and himation, as above described, continued 
to be the standard dress from 450 B. C. onward. 

The hair was most usually worn gathered back from the 
temples, and fastened in a knot behind by hair-pins of 
ivory or bone, either plain or mounted with gold. 



254 PERSONAL HYGIENE FOR WOMEN 

For the feet, sandals were usually worn, in exceptional 
cases shoes, and for hunting, high boots. Gloves were 
never worn by the Greeks, except to protect the hands in 
working. 

From the time of Pericles, the great European distinc- 
tion between male and female dress consisted in the length 
of the skirt, old men, priests, and officials being allowed the 
privilege of wearing long or women's skirts, and young 
girls being permitted to wear the short or man's skirt. 
Among the Romans, this single garment, worn by both 
sexes, was called the toga. 

As time rolled on, this loose cord, which had formed the 
girdle, was reinforced by a broad belt or band to support 
the breasts. Among the Assyrians this belt was made of 
stiffened linen or thin metal ; the Egyptians wore a folded 
belt; a broad belt for supporting the breasts was also worn 
by the Roman ladies. But whatever the material used, 
this stay-belt does not show any signs of tight laces or of 
vertical ribs of iron or bone. It was, however, the fore- 
runner of "stays," and when the moral fiber of the Greeks 
grew lax, the courtesans set the fashions, and dress was 
used to display rather than to conceal the figure, and, in 
order to make the hips more prominent, the waist was con- 
stricted by a many-layered belt. At the same time, the 
use of cosemtics was introduced. 

The Mediaeval or Middle Ages. — From the end of 
the fifth century to the beginning of the seventeenth there 
was a singular resemblance in many marked particulars 
between the dress of the two sexes. It now became the 
object of dress in both sexes not merely to clothe the 
person, but also to display the figure and adorn it. In 
the temperate climates there are always greater changes in 
fashion than in the very hot or very cold. 

Subjugation by the Romans in the first centuries of the 
Christian era was followed by a general conformity to their 
mode of dress, so that the Roman dress may be considered 
to have become European. 

In marked contrast to the loose, flowing robes worn by 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 255 

the southern nations of Europe in their decadence were 
the short skirts and jackets clinging to the limbs, which 
were worn by the hardy nations of the North; who were 
given to constant fighting and the pursuit of the chase. 
The Norman lords, following the fashion of the south, 
swept about in long tunics and flowing robes. 

In the twelfth century the Anglo-Saxon women, dressed 
in their loose garments, were indebted to the Norman 
ladies for the introduction of "stays," and the fashion of 
tightly lacing the body with a robe, laced down in front 
in order to show its undulations, as well as the use of cos- 
metics. 

In the household register of Eleanor, Countess of Leices- 
ter, which bears the date of May 24, 1265, is one of the 
earliest places in which the word corset occurs. The 
word is again found in reference to the wardrobe of Richard 
King of the Normans, and Edward his son. Corsets were 
at this time worn by men as well as women. 

The author of the life of St. Thai's, who lived in the 
twelfth century, tells us that the French were so tightly 
laced that they could bend neither their bodies nor their 
arms. 

Peter the Great wrote that the robes are so tightly 
stretched over the body, that the ladies can scarcely breathe 
in them, and often suffer very great pain in order to make 
their bodies slender. 

It was in the thirteenth to the fourteenth century that 
the last trace of the Roman drapery gradually disappeared: 
the women adopted for the most part the robes with the 
tightly fitting corsage, leaving ordinarily uncovered the 
neck and the skin of the breast ; this closely fitting corsage 
was closed in the back by lacing. 

Boots and shoes of this period had their pointed toes 
made two or three times the length of the wearer's foot. 
The fashions of England were the same as those of France, 
though apparently they were not carried to quite the same 
excess as on the continent. The singular aim of each sex 
was not only to emulate the other in the sumptuous style 



256 PERSONAL HYGIENE FOR WOMEN 

of dress and its profuse adornment, but also to imitate the 
form and fashion of the other's attire; this obtained in both 
countries. 

The Renaissance. — In the sixteenth century a distinct 
separation between ancient and modern dress took place, 
and our present fashions took their origin from about that 
time. It was during this century that men adopted clothes 
closely fitting about the body, overcoats with tight sleeves, 
felt hats with more or less rigid brims, and closed boots 
or shoes. The women also wore their dresses tightly 
fitting to the figure, with tight sleeves, low-crowned hats, 
and richly trimmed petticoats. These garments, which 
differ wholly from antiquity, constitute, as it were, the 
common type, from which has risen the endless variety 
of modern male and female dress. 

At this time the general resemblance between the cloth- 
ing of the two sexes, which may be traced to the earliest 
times, became decided. After the accession of Queen 
Elizabeth in 1558, the well-known costume, associated 
with herself from about the middle to the close of her reign, 
gradually became established. The long-peaked and tight 
stomachers of the ladies, and the padded quilted doublets 
of the men — it might truthfully be said that each garment 
was a parody of the other. 

Ruffs of an exaggerated amplitude and of a painfully 
severe stiffness were worn by both sexes. 

At the beginning of the seventeenth century the dresses 
were tight at the waist, but begun to be made very full 
around the hips, by means of large padded rolls, which were 
still more enlarged by a monstrous arrangement of padded 
whalebone and steel. To both boots and shoes high heels 
were added, in place of the flat heels previously worn. 

About 1710 the hooped petticoat was introduced, and 
about 1740 they obtained enormous dimensions. 

When traced to their original sources, we find that all of 
the extremes of fashion were made to conceal some deform- 
ity of the figure, or to give to a part of it undue prominence, 
as in the case of the corset, which was first introduced when 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 257 

clothes were not wanted for the concealment of the person, 
but to make more prominent the curves and undulations 
of the figure. The ruff grew out of a scrofulous complaint 
on a royal neck; the hoop-skirt, to conceal the enceinte 
condition of a French queen. 

The Corset in History. — Dr. Bouvier divided into five 
epochs the transformations undergone by the corset, or 
by that part of the clothing which took its place from 
earliest antiquity to 1853. 

The first epoch is that of antiquity; in this, as we have 
seen, the band or girdle, which was worn by the Greek 
and Roman ladies, was the forerunner of the corset. 

The second epoch comprises a great part of the Middle 
Ages. This was a period of transition which partook of 
the styles which preceded and followed it. At first there 
was an abandonment of the narrow Roman band, and 
later the introduction of the corsage fitting tightly about 
the body. 

The third epoch embraces the end of the Middle Ages 
and the first part of the Renaissance, which was marked 
by the general adoption of robes with a very tightly laced 
corsage. 

The fourth epoch is that of the whaleboned corset, 
which extended from the middle of the sixteenth century 
to the end of the eighteenth. 

The fifth epoch is that of the modern corset. 

The busk, known since the fourth century, was intro- 
duced into France in the sixteenth century; men also 
wore busks or stomachers. The busk relates closely to 
the history of corsets. The middle of the sixteenth 
century is the epoch of transition from the corsage to the 
whale-boned waist, which constituted a sensible approach 
to the modern corset. 

We find that the reign of Queen Elizabeth was marked 
by the first use of the whalebone stays. These were much 
affected by her successor James, who insisted that all 
his courtiers, male as well as female, should cultivate 
the appearance of the wasp. 

17 



258 PERSONAL HYGIENE FOR WOMEN 

The corset of George II, represented in Hogarth's 
pictures, is said to have been one of the most harrowing 
forms of screw torture. We are told that the doughty war- 
riors of Gustavus Adolphus wore stays almost to a man. 

To Catherine de Medici is generally attributed the 
introduction of the closely whaleboned waist into France, 
and the corset which she invented resembled in more 
than looks that instrument of torture — "The Machine 
Virgin of the Inquisition. " This corset was made of steel, 
and was as inflexible as a suit of armor, and, like a war- 
rior's breast-plate, consisted of two pieces. It opened 
longitudinally by hinges, secured by a hasp and pin, 
made like an ordinary box fastening. In the front and 
back a rod or bar of steel projected in a curved direction 
downward, and on their bars depended the adjustment 
of the long-peaked body of the dresses and the set of the 
skirt behind. During the forty years in which she ruled 
at court a thirteen-inch waist measure became the accepted 
standard. 

Madame de SeVigne*, born thirty years after the death 
of Catherine de Medici, formulated the axiom which 
has since been a law to the French modiste, " Les hommes 
ont la permission d'etre laid; les femmes ne Font pas; 
aussi n'en est-il aucune qui consente a Fetre." 

The idea of the waist was unfortunately that which 
concerned the execution. Instead of being adapted to 
the body or figure, in accordance with its form, to bend 
with its movements, as the supple corsage which preceded 
it had done, this new garment became an inflexible mold, 
which distorted the natural contours and imposed upon 
them a conventional mold, and prevented the least 
variation of size or situation of the contained organs, 
as well as their continued integrity and the proper per- 
formance of their functions. 

The use of the whaleboned corset prevailed even among 
infants scarcely out of their swaddling clothes. This 
was the natural consequence of the pretended necessity 
to mold the human form in order to obtain beautiful pro- 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 259 

portions, to reform nature, and prevent her mistakes, 
and one could never take too much care to obtain such 
laudable ends. Mothers would have been considered 
culpably indifferent of their children who had neglected 
these first indispensable cares for the regulation of the 
formation of their bodies. 

The Crusade Against the Corset. — From the time of 
Galen, 130 A.D., to the present day, in spite of the ana- 
themas hurled against it by the state and medical profes- 
sion, denouncing this great injury which woman does 
herself, has the corset still prevailed. 

In the thirteenth century, Henry III, having per- 
mitted its use for some time, proclaimed a very severe 
edict against the wearing of corsets, which was considered 
so pernicious to the health of women, but of no avail. 

In the fourteenth century an edict was issued by the 
Emperor Joseph of Austria, forbidding the use of corsets 
in all nunneries and places where girls were educated, and 
calling upon the Church to aid him, threatening excom- 
munication to those evil-disposed damsels who should 
persist in operating upon their waists. The College of 
Physicians of that day took up the subject with activity 
and zeal, and dissertations upon the evils of tight lacing 
were scattered broadcast. 

Professor Virchow, that eminent pathologist, wrote, 
" What is the use of introducing the principles and appli- 
ances of hygiene into the huts of the poor and ignorant, 
when the scions of wealth and pretended intelligence, 
especially of the gentler sex, show their contempt of 
hygiene by their dress and general wearing apparel. In 
days gone by I have battled against that diabolical 
invention called the corset, but this crusade has been 
given up by me as absolutely futile." 

The modern hygienist has taken the stand that, since 
the corset cannot be suppressed, it must be reformed. 
About 1880, for the first time, some attention began to 
be given to the hygienic consideration of the style of the 
corset. 



260 



PERSONAL HYGIENE FOR WOMEN 



The Influence of the Corset on the Female Body. — 

As a result of the four hundred years in which the corset 
has molded the plastic form of woman, she has become 
physically so degenerated that it is necessary to have 
recourse to the artifices of the modiste in order to have 
even the appearance of a good figure, and the support 
afforded by the corset to maintain the erect position. 

The modern corsets, made of one piece, can be classified 
in three categories, according to the region of the body 





Fig. 13. — Normal chest. 



Fig. 14.— Effects of tight lacing 
on bony thorax. 



on which they exert the greatest pressure. First, the 
"curved front " corset, enveloping the thorax and 
abdomen, but making the strongest compression at the 
base of the thorax; second, the "straight front " corset, 
enveloping the thorax and abdomen, but making the 
strongest pressure upon the abdomen; and third, the 
"abdominal corset," only embracing the abdomen, and 
supporting neither the breasts nor the base of the thorax. 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 261 

In studying the effects of the corset on the body they 
will be considered in this order. 

The Curved Front Corset. — The corset is applied to the 
trunk of the body, consisting of the thoracic cavity, a 
distensible cage containing and filled by the heart and 
lungs; second, the abdominal cavity, whose walls are 
almost wholly composed of muscles, and containing the 
liver and the entire digestive apparatus; and third, the 
pelvic cavity, whose walls are partly bony and partly 
muscular. 

When the anterior wall of the body is forced to take 
the shape of this curved corset, it is pressed back toward 
the vertebral column, and even when the corset is not 
laced tightly, there is always more or less constriction of 
the base of the thorax, so that a serious deformity of the 
lower part of the thorax and abdomen is produced; instead 
of the normal outward curve of the anterior surface of the 
body, with its most prominent part in the region of the 
umbilicus, there results a broken line at the waist, and 
an obtuse angle is formed here, pointing outward. This 
causes a marked incurvation of the lower part of the 
chest and its approach toward the spinal column, with a 
corresponding flatness of the chest and lessening of the 
respiratory capacity of the lungs, and the action of the 
heart is seriously interfered with. 

The chest or thorax is forced into the shape of a cone, 
the lower opening is narrowed, and its walls are brought 
too near together. The lower ribs become too short, and, 
if the corset is worn early in life, the upper ribs become 
too long; and the thorax as a whole is too long. 

The greatest constriction produced by the corset occurs 
in the plane extending from the ninth to the twelfth 
ribs, which corresponds to the position of the diaphragm, 
stomach, and liver. 

Just how seriously the curved corsets interfered with 
the expansion of the lungs was shown in a paper pub- 
lished by Dr. Sargent in 1889. He found that the average 
lung capacity when corsets were worn was one hundred 



262 



PERSONAL HYGIENE FOR WOMEN 



and thirty-four cubic inches; when corsets were removed, 
the lungs showed a capacity of one hundred and sixty- 
seven cubic inches — a gain of thirty-three cubic inches; 
that is, corsets crippled the lungs to the extent of one- 
fifth of their entire capacity. 

Nature endeavors to make up this loss by the increased 
rapidity of the heart's action and more frequent respira- 
tions, but this is at the ex- 
pense of greater wear and 
friction of the machinery. 
Palpitation and shortness of 
breath follow, and the woman 
is obliged to give up all active 
exercise. 

Through this failure of the 
suction power of the heart 
there result disproportionately 
larger lower limbs and an ac- 
cumulation of adipose tissue 
below the waist. This condi- 
tion is much more common in 
women than in men, and is 
due to the lack of power of 
the heart to draw the blood 
back from the lower limbs 
against the force of gravity. 
Hence, the blood tends to linger 
in the lower extremities and 
the oxidation of the tissues is 
interfered with. 
The Relation of Corsets to Abdominal and Pelvic Dis- 
orders. — By the constriction of the lower part of the 
thorax, as we have seen, the action of the diaphragm is 
very greatly impaired; this not only seriously interferes 
with its respiratory function, but with digestion as well, 
since, by the active contraction of the diaphragm in in- 
spiration, it presses down the liver and other abdominal 
contents, and produces a powerful massage of those organs, 




Fig. 15. — Diagram show- 
ing the action of the curved 
front corset (O'Followell). 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 263 

which aids in the digestion of food and in the unloading of 
the bowels, and, at the same time, the pelvic circulation is 
interfered with and pelvic congestion is favored. 

The direct pressure of the corset upon the side walls 
of the chest forces the ribs in upon the abdominal contents; 
the liver suffers most from this, and not only does the liver 
sometimes actually show furrows upon its surface from 
the pressure of the ribs, but, in the postmortem room 




Fig. 16. — Relation of bony thorax to lungs, heart, liver, and stomach, 
with artificial outline produced by corsets (after Gray). 

of the great Vienna Hospital deep grooves upon the 
liver were repeatedly found with great distorsions of the 
body caused by the corsets, and, in a few instances, the 
left lobe of the liver was found to be nearly separated from 
the right. 

By the constriction of the waist, the liver and all the 
abdominal contents are pushed downward below their 
normal position, and their functions are greatly inter- 
fered with. The effects of this pressure upon the stomach 



264 PERSONAL HYGIENE FOR WOMEN 

are most disastrous, and cause a host of digestive and ner- 
vous troubles. There is very frequently a prolapsus of 
the kidneys; the right one is more frequently prolapsed 
than the left, owing to the relation of the right kidney to 
the liver. 

In a study of 50 cases Dr. Gallant found that in 90 
per cent, the stomach was pushed down below its normal 
level, and in 80 per cent, there was prolapsus of the right 
kidney. 

The constriction of the waist crowds the small intestines, 
with the accompanying mesentery and colon, into the 
pelvis; if the rectum is loaded with feces and the bladder 
empty, there follows an anterior displacement of the 
uterus; if, on the other hand, the rectum is empty and the 
bladder distended, there is a backward displacement of 
the uterus. In very many of these cases the compression 
and constriction are great enough to interfere with and 
retard the peristaltic action of the intestines, and con- 
stipation is produced. 

Gynecologists are unanimous in the opinion that tight 
lacing is a most serious impediment to the development 
of the pelvic organs, and is a prominent factor in causing 
disease of these organs. Tight lacing displaces the uterus 
downward from two to three inches, and, at the same time, 
the pelvic floor is bulged downward from two and one- 
half to three inches and the circulation rendered sluggish. 

When there is no interference with the respiratory 
movements the uterus rises and falls with every breath, 
and the movements of the uterus promote the circulation 
of the blood in the pelvis. 

A high corset compresses the breasts, and so interferes 
with their development. The low corsets of the present 
day support rather than compress the breasts. 

The Effects of Corsets on the Muscles. — In the back the 
corset forms an extended plane from top to bottom, 
destined to support the posterior part of the thorax 
and to diminish as much as possible the size and pro- 
jection of the shoulder-blades. This compression of the 



265 

muscles of the back leads to their atrophy, and, as it is 
their function to hold the spinal column erect and to ap- 
proximate the shoulder-blades to the thorax, when they 
become atrophied the bony parts become much more 
salient. Further, the corset, in weakening the muscles 
of the dorsal region, interferes with the normal forward 
projection of the chest, and so leads to its flatness. 

The corset atrophies the articulations of the vertebral 
column, produces a round back, an inequality in the height 
of the hips and shoulders, with the resulting familiar 
awkward, waddling gait. 

When the healthy skeleton offers to the muscles of the 
body a solid base of support, the action of the muscles of 
the back are not interfered with, there is nothing to prevent 
their contraction, and the body is held erect. With a 
perfect muscular development, the shoulders are effaced, 
the back is admirably straight, and the carriage is erect 
and graceful. 

The strong compression of the muscles of the abdomen 
not only destroys the normal contour of the body, but, by 
the atrophy of the abdominal muscles, a partial paralysis 
is caused, and so the support which should be afforded the 
viscera by these muscles is weakened, and a prolapsus of 
the abdominal contents follows. 

It will be seen that the two bony cavities of the body 
are connected in the back by means of the vertebral column 
and are not immovably fixed in relation to each other, but 
by reason of the flexibility of the spinal column, they can be 
approximated or the distance extended. The suppleness 
which results from this mobility corresponds to the physio- 
logic needs, and constitutes one of the most essential con- 
ditions for gracefulness of carriage. 

The movements of extension of the chest are rendered 
possible by the action of the muscles of the back, which 
hold the trunk erect and extend the vertebral column. 

When the corset is applied, the compression and con- 
striction fix all those portions of the muscles at and below 
the waist; the action of the muscles between the chest 



266 



PERSONAL HYGIENE FOR WOMEN 



and pelvis is diminished at least one-half, so that these 
muscles become atrophied from disuse, and when the 
corseted woman wishes to straighten up the movement 
must be executed by the entire trunk. 




Sternum 



The vertical dotted line 
indicates the straight 
muscles of the an- 
terior surface of the 
trunk shown in Fig. 
18. 



•Pelvis 



Fig. 17.— Skeleton of head and trunk (O 'Folio well). 



Without the corset, the pelvis remains fixed and 
furnishes the normal base of support for the thorax, 
which gains the erect position through the action of 
the muscles of the back acting on the vertebral column. 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 267 

Whereas, with the corset on, the pelvis is immobilized, 
and it follows the movements of the thorax. The move- 
ment of extension of the thorax, instead of taking place 
in the region between the false ribs and pelvis, take 
place at the hip-joints — the vertebral column remains 
rigid, it takes no part in these movements. 

Then, as a result of the incurvation of the anterior 
surface of the trunk, there is an interference with the 




Fig. 18. — Muscles of the anterior surface of the trunk (O 'Folio well). 



movements of extension of the spine and its immobiliza- 
tion, which causes the propulsion forward en masse of 
the abdominal contents. The anterior portion of the 
chest is shortened, and an exaggeration of the sacro- 
lumbar angle is produced. 

On the sides of the body lateral flexion of the trunk is 
possible, through the contraction of the muscles between 



268 



PERSONAL HYGIENE FOR WOMEN 



the chest and pelvis, but with corsets on this is impossible. 
The two cavities are fixed by the rigid armature which 
composes the corset. This not only prevents the lateral 
flexions of the body, but also causes an unnatural depres- 
sion above the crests of the ilium. The waist is con- 
stricted to such an extent that the woman can only 

fasten her corsets in front by 
having them widely separated 
in the back. 

All these conditions cause 
a complete immobilization 
of the thorax on the pelvis, 
so that the movements of 
the upper part of the body 
are characteristic in corseted 
women, and she moves all in 
one piece. 

The Straight Front Corset. 
—This corset, when worn 
loose, is a great improvement 
on the curved-front corset. 
When properly fitted, all the 
compression comes at the 
hips and across the lower 
part of the abdomen, which 
is lifted up, and the waist-line 
is increased in size. This 
corset has for its base of 
support the bony pelvis, and 
there should be sufficient space to easily introduce the 
hand between the lower part of the thorax and the corset. 
In this case there is great freedom of movement of the 
entire chest cavity, so that respiration is not nearly so 
much interfered with as in the curved-front corset, and 
if the corset is properly fitted, the lower part of the 
abdomen is raised together with the contained viscera, 
and, indeed, this style corset is prescribed in cases of 
prolapsus of the kidneys. 




Fig. 19. — Diagram showing 
the action of the straight front 
corset (O'Followell). 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 269 

By having the base of support from the bony pelvis, the 
chest is left free, and a good chest expansion and its 
throwing forward is favored, and at the same time an 
erect carriage is secured. 

The waist-line runs below the short ribs, which lengthens 
the waist, producing graceful lines without compression. 

But not all straight front corsets fill these conditions. 
Unless sufficiently long and well fitted about the hips, 
they may fail to raise and support the abdomen, and 
when too tightly worn may press too strongly upon the 
abdomen in the pretext of obliterating it, with the result 
that it is placed in a vice from before back. Pressed 
down, the intestines find a means of escape at the lower 
border of the corset. 

The front of the corset is frequently carried too high 
up, and does not leave the epigastric region sufficiently 
free. The corset must absolutely not be thoracic, and 
must definitely renounce the support of the breasts, 
which should be accomplished when necessary by an 
extra bust supporter. The long straight corset im- 
mobilizes the trunk in the same manner as the curved 
front corset. 

The Abdominal Corset. — In 1902 Madame Gaches- 
Sarraute proposed to abandon the thoracic corset and to 
introduce instead the abdominal corset. This corset 
embraces the pelvis without compressing it, and takes 
as the foundation of its support the bony girdle ; the plan 
of the line of support is oblique, and inclined forward 
in such a way that there can be no compression. 

In this way the pressure, instead of coming from above 
and annuling the contractions of the abdominal muscles, 
comes below and reinforces their action; the stomach 
resumes its normal position, and is supported in the plane 
of its greater curvature, facilitating its functions, so that 
digestion will be performed under the most favorable 
conditions. 

The abdominal corset should not exceed the height of 
the false pelvis, should have as the base of support the bony 



270 



PERSONAL HYGIENE FOR WOMEN 



girdle of the pelvis, and should be rectilinear in front 
and very slightly curved in the back and below. The 
hips should be simply surrounded and their projection 
preserved. A curve which follows the normal sinuosity 

of this plane joins the piece 
from the hips with that of the 
abdomen. 

The part corresponding to 
the back must be sufficiently 
wide and free, so that the pos- 
terior borders of the corset will 
be parallel when it is put on, 
and the plane preserved for the 
back in the pieces which form 
the corset. This garment will 
be adjusted without strain in 
the back, and it will embrace 
the form of the body so exactly 
that it can be put on without 
being unlaced. 

The frame of the corset must 
be reduced to a minimum — a 
rigid busk in front and some 
whalebones in the back; the 
hips remain free, and a slight, 
separate brace supports the 
breasts. 

The Wearing of Corsets 
by Young Girls. — The greatest 
dangers come from putting cor- 
sets on young girls who are still growing and are very 
imperfectly developed, and later by an undue constric- 
tion of the lower part of the thorax and the waist, so 
that the development of the entire body and its organs 
is seriously interfered with and all beauty of form is 
prevented. 

The muscles of the back, like those of the abdomen, 
are prevented from their full development, and, later, 




Fig. 20. — The abdominal cor- 
set (O'Followell). 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 271 

in their action, by the use of the corset. The earlier the 
corset is put on, the more pernicious will be the effects, 
because during the period of growth the bony frame- 
work is more pliable and delicate, so that a relative slight 
compression is sufficient to make an indelible impression 
upon the form. Before the complete development of 
the hips and the entire bony framework an enormous 
amount of harm is done by the wearing of corsets. 

In early youth the heart lies higher than in the adult. 
By narrowing the intercostal spaces, the heart is retained, 
as it were, in its youthful position; in the adult female 
the heart is found to He higher than in the male, and 
the contraction of the space in which the heart has to 
play is one of the causes of woman's fainting, and it is also 
a cause of organic disease of the heart. 

At puberty, when the girl is rapidly increasing in stature, 
and her menses begin to be a drain on the system, relentless 
custom adds the compression of the corset and long skirts, 
suspended from tightly drawn bands around the waist. 

The spinal column at this age lengthens rapidly, and 
it should carry upward all the viscera attached to it; 
but, owing to the weight of the clothing and the com- 
pression at the waist, this normal process cannot take 
place; instead, there is stretching of the ligaments, and 
the viscera are prevented from rising and hang at a levei 
much below the normal. 

A girl of this class is apt to be slender, with under- 
sized hips, and has a characteristic configuration of the 
anterior surface of the body, a hollowing out of the region 
over the stomach, and a very great protrusion of the 
abdomen. 

The uterus remains undeveloped and in an infantile 
state until near the approach of puberty, when it develops 
rapidly, and continues to increase in size until the normal 
size is attained — about twenty years of age. By the 
putting on of corsets the free mobility of the uterus and 
its appendages and their normal development are inter- 
fered with. 



272 PERSONAL HYGIENE FOR WOMEN 

This period of growth and development is one of the 
greatest importance for the future health of the woman, 
both physically and mentally, and the most intelligent care 
should be given the girl at this impressionable age. By 
putting corsets on their daughters at this time, mothers 
are doing them a very great wrong, which can never be 
entirely atoned for. The corset prevents growth, develop- 
ment, and the participation in those exercises which make 
for physical vigor and good health. To the well-developed 
girl corsets are as much of a superfluity as crutches would 
be, and nothing but the prevailing style of dress causes 
girls to put them on. 

It has been suggested that the wearing of any kind of 
corsets before thirty years of age should be a penal 
offense; and in case of a minor, the parents should be 
fined from one hundred to one thousand dollars. 

As regards the wearing of corsets after the age of thirty, 
opinion is divided into three clases — first, those who 
utterly condemn their use; second, those who approve of 
it; and third, those who tolerate the wearing of corsets, 
but only under the condition that they shall cause ab- 
solutely no constriction. 

What Style of Corset is the Least Injurious? — From 
the nature of the structure of the chest and abdomen and 
the functions of respiration, circulation, digestion, and 
the pelvic organs, the wearing of any style of corset must 
be more or less detrimental to the health and vigor of 
woman, and a perfectly developed woman, in perfect 
health, does not need a corset if she lives under normal 
conditions of dress and life; but in our present state of 
civilization, with the present style of dress, and with the 
very imperfect muscular development, women in and past 
the prime of life may wear hygienic corsets without any 
very great amount of injury. 

The type of feminine beauty which approaches most 
nearly the ideal is that of harmony of proportions and 
modulations of lines. The waist proportions of the Venus 
de Milo is 47.7 per cent., while that of the Grecian man is 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 273 

46.4 per cent. In proportion to her height the hips of the 
modern woman exceed the girth of those of a man by 
about four inches, and a woman of the same height as a 
man exceeds in hip girth by six inches. If the muscles 
which pass from the thorax to the pelvis were properly 
developed, the artistic proportions would be preserved, and 
the waist of the woman would be proportionately larger 
than those of a man. 

The ideal figures of the Greek women show a torso 
bounded by outward curves, softly melting into one an- 
other, until the broadest part is reached at the hips, thence 
again declining to the feet. The line from the armpit 
to the ankle is one of the chief fines of beauty in sculpture, 
while the anterior surface of the body should present, in 
the median line, a gentle curve from the upper end of the 
breast-bone to the brim of the pelvis, the convexity of the 
curve coming about the umbilicus. An inward curve of 
this line is a deformity artificially produced. 

In order that the corset should become an inoffensive 
garment it must be well adapted to the figure, so that it 
shall not embarrass the action of the diaphragm or the 
vital organs or the movements of the body. 

The injurious effects of wearing the curved front corset 
have been given, and this style of corset should be con- 
demned without appeal, since its use is dangerous from 
every point of view. 

The straight front corset is much less injurious than the 
curved front, but its use is detrimental to health, and 
prevents the free movements of the body, so that the 
abdominal corset remains the only one which is perfectly 
safe and at the same time esthetic. 

The chief role of the corset must be to sustain the cloth- 
ing and to prevent the constriction of the lines about the 
waist and to prevent the falling of the viscera. 

This can only be accomplished by selecting the proper 
points of support for the corset; this is in the lumbar region 
of the spine and the crest of the bony pelvis, a region of 
several centimeters in height. Except for the vertebral 

18 



274 PERSONAL HYGIENE FOR WOMEN 

column, the viscera of the region immediately above this 
have no bony protection, and are subject to the greatest 
amount of constriction, the organs being piled up on top 
of each other, as it were, and thereby suffer very great dis- 
placement and impairment of function, while, on the other 
hand, the solidity of the bones of the pelvis permits of 
their use as a base of support for the corset, as well as for 
the clothing. 

It is based on this idea that the hygienic abdominal 
corsets are built, and, further, this style of corset does not 
sacrifice the normal curve of the anterior surface of the 
body. That the abdominal corsets do not support the bust 
is no detriment, as the woman with very fully developed 
breasts can wear a bust supporter, entirely separate from 
the corset, and in those pathologic conditions of ptoses 
of the abdominal contents — and from an orthopedic point 
of view, the abdominal corset affords an excellent solution. 

In order to prevent misfits, all corsets should be made to 
order; the measurements must be taken with the corsets 
removed. The corset must be shaped so as to fit exactly 
over the hips, with the lower parts of the busks very slightly 
curved, following the normal curve of the body. The 
upper part of the corset must be a little loose, in order to 
permit of the easy movements of the body. Behind, the 
line of the corset must correspond to the line of the body, 
in order not to interfere with the erection of the body. 
In front, the corset overlaps the pubic bones, and must 
be tight enough to give the abdominal contents some 
support. 

Instead of the lacings forming two "V's," the lower V, 
with its apex at the waist-line, and the longer V superim- 
posed on top of this, the ensemble of the lacings to be 
normal must form only one V, with the inferior point 
very elongated. The corset is too tightly laced if, when, 
with the strings untied at the waist, the upper parts of 
the corset separates. 

The corset should be put on with the lacings wide open, 
be carefully adjusted in the proper position, and fastened 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 275 

from below up. After the stocking supporters have been 
attached, the lower part of the corset is held down with one 
hand, while the other hand gently draws up the abdomen 
by means of drawing on the undervest, or slipping the hand 
within the corset; in this way the abdominal organs are 
lifted up. The corset is then laced from its lowest point 
to the waist-line, and from the top to the waist-line, in 
such a way that only one long "V" is formed. The laces 
are then firmly tied and slipped in under the corset. 

Corsets that slip up are probably either too long waisted, 
too tight over the fulness of the hips, or there is not suffi- 
cient curve in the back and sides at the waist-line. High- 
backed corsets are apt to make the woman look round 
shouldered, while a low back gives smoother and more 
desirable fines. 

The Shoe. — The style of the shoe is very closely related 
to the corset in the amount of harm it is capable of doing. 
Considering the fact that the feet form the base of sup- 
port for the entire body, and that on their condition 
depends the woman's ability to take a sufficient amount 
of exercise and maintain her good health, surprisingly 
little attention is given to their care. 1 

The compression of the foot into a rigid body, not 
unlike the shoemaker's last, destroys the natural relation 
of the parts, prevents the growth, interferes with the 
circulation, compresses the nerves, weakens muscles and 
ligaments which should support the arch, and is the prolific 
source of corns, bunions, weak ankles, and "flat" foot. 

But, in addition to the direct injuries to the feet, the 
excessive elevation of the heel displaces the center of 
gravity, and transfers the weight of the body for the 
most part from the heel to the line of union of the instep 
with the toes, a series of joints with shallow sockets 
not formed to bear the brunt of the body weight. In 
addition to which the equilibrium of the body can only 
be maintained by an increase of the natural curves of the 
bony framework, with the resulting increased curvature 
forward at the small of the back, is an increase in the 
1 See pages 337 and 339. 



276 PERSONAL HYGIENE FOR WOMEN 

prominence of the buttocks and abdomen. This tilting 
forward of the pelvis interferes with the circulation of the 
pelvic organs, and their congestion and inflammation follow. 

By walking around in her bedroom slippers any one 
can easily convince herself of the greater grip that the 
foot has on the floor when so clad, and of the greater 
ease and sureness in walking; this is chiefly due to the 
greater breadth of the sole, and the fact that the slipper 
has no heel. The greater firmness of men on their feet 
on slippery pavements is doubtless due to the difference 
in the cut of the shoe and the lower and broader heel. 

The front part of the sole of the shoe must be so de- 
signed that the great toe will retain its normal position 
and rest on the inner border of the sole. In many shoes 
the great toe is forced out of its natural position toward 
the middle of the sole, and the tip, instead of pointing 
straight forward, is thrust toward the line of the sole. 
This not only lessens the thrust of the great toe as it 
leaves the ground in walking, but also leads to a malforma- 
tion of the foot and ingrowing toe-nails. 

The soles of the shoe should project a reasonable distance 
beyond the uppers, to give firmer support to the foot and 
to protect the soft parts in walking. 

The front part of the upper leather must be broad 
enough for the free movement of all the toes in walking 
and in springing; when it does not give room enough 
for the toes to spread outward and forward in walking, 
they are bent on themselves. This makes the descent 
of hills and all active exercise and games very painful. 
Tight upper leather is also productive of chilblains and 
corns. 

The shoe should be slightly longer than the foot when 
the entire weight of the body is placed upon it, and 
sufficiently broad for the foot to spread in walking; but, at 
the same time, the shoe must fit snugly about the heel 
and instep, or else the foot will slip forward in walking, 
and all the evil effects of too short a shoe will result. 

The heel of the shoe must be broad and low. High 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 277 

heels force the foot to keep perpetually and unnaturally 
on the stretch; if they are worn in early youth, they may 
bring about permanent deformity of the skeleton and of 
the foot. Moreover, the high heel interferes with the 
natural walk, in which the pressure of the foot on the 
ground passes from the heel to the toes. The high heel 
requires that the front of the foot should be set down 
first instead of the heel. The result is an awkward trip- 
ping gait and a short step, which is very fatiguing. This 
is one of the causes for woman's frequent dislike for 
exercise in the open air, such as walking, mountaineering, 
games, etc., and so the general health is affected. 

Again, from the esthetic point of view, the size of the 
foot must be in proportion to that of the body. Artists 
declare that every foot that has worn a shoe is deformed, 
and so, when they wish to make a study of the foot, they 
go to the shores of Italy, where the peasant women have 
never worn shoes. 

Paget's description of a perfect female foot is great 
breadth and fulness of instep, a well-marked great toe, 
a long second toe, projecting a little beyond the great toe, 
and a very small little toe. 

Since the feet are the part of the body to come in direct 
contact with the greatest amount of cold, whether on the 
floor of the house or the pavement of the street, it is a 
matter of prime importance to the entire body that they 
should be warmly clad. While for house wear and in the 
summer time a French kid is a most comfortable shoe, 
for street wear and outdoor exercise in cold weather a 
heavier leather with thick soles is requisite as a protec- 
tion against the cold and damp. 

Rubbers should always be worn when the pavements 
are damp, even if it is not raining, and in snow-storms 
and very heavy rains cloth gaiters should be worn over the 
shoes, to keep the ankles dry, and later to protect them 
from the wet skirts. 

The Stockings. — Great care must be taken to have 
the foot of the stockings sufficiently long and loose; this 



278 PERSONAL HYGIENE FOR WOMEN 

is doubly the case with woolen stockings, which are apt 
to shrink so much in the wash. A too tight or too short 
a foot of the stocking interferes with the circulation and 
causes a cold foot, and when the stocking foot is too 
short, it produces the same deformities that too short a 
shoe does. 

The trouble generally begins in childhood; mothers 
forget in buying stockings for their children that stockings 
shrink in the laundry and that children's feet grow. 
The result is that the stocking-foot is apt to be too short 
before it is worn out, and so the toes are bent or cramped 
together, and there is the starting-point for deformities 
of the feet as well as corns and bunions. As much harm 
may come from wearing too short a stocking-foot as too 
short a shoe. 

Again, with the present mode of wearing the stocking 
supporters attached to the corset, or, indeed, one of the 
functions of the stocking-supporters may be said to 
be the holding down of the corsets, the supporters are 
shortened for this purpose, and as a result the entire 
foot of the stocking is pulled on, and an artificial shorten- 
ing of the stocking-foot is produced; and this point must 
be borne in mind in purchasing stockings. 

Woolen stockings should always be worn during the 
cold weather. Garters should never be worn around the 
leg, whether above or below the knees, since, in order 
to be sufficiently tight to hold the stockings up, they 
interfere with the circulation by the constriction of the 
leg, and so cause cold feet and greatly increase the trouble 
in case of varicose veins. 

The Essential Qualities for Winter Underclothing. 
— These are that the clothing must be light, loose, warm, 
and equally distributed over the body. From the hygienic 
standpoint, the underclothing is the most important part 
of the dress. 

We have seen that much of the energy of the body is 
spent in maintaining its normal temperature, and that the 
two main functions of the skin are the preservation of the 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 279 

normal body temperature and the excretion of certain 
effete matters in the form of watery vapors. 

In the temperate zones two qualities are required of 
underclothing — that it shall prevent the too rapid radia- 
tion of heat from the body and that it shall be absorbent. 
No material is warm per se. The warmth is necessarily 
derived from the body, so that what is required of the 
underclothing is that it shall confine the warmth in its 
meshes; atmospheric air being one of the poorest con- 
ductors of heat, the material should be so constructed as 
to imprison a considerable quantity of air in its meshes. 

The second necessity is that the excrementitious matters 
should be rapidly absorbed, as they are being constantly 
poured out from the s£in, so that the material must be 
absorbent in the highest degree, otherwise the fluids re- 
main in contact with the skin to irritate it, and the atmos- 
pheric air confined between the undergarment and the 
skin rapidly becomes surcharged with gases and moisture, 
and so acts like a warm jacket around the skin. Heat 
radiation is interfered with and the skin becomes extremely 
sensitive to changes of temperature and to drafts. 

Wool is a poor conductor of heat and a great absorber 
of water. Its powers of hygroscopic absorption is at 
least double in proportion to its weight, either cotton or 
linen, and this property is an important one. During 
perspiration the evaporation from the surface of the body 
is necessary to reduce the heat which is generated by ex- 
ercise. When exercise is finished, evaporation still goes 
on, and, if unchecked, to such an extent as to chill the 
body. If dry woolen clothing is put on after exertion, the 
vapor from the surface of the body is condensed in the 
wool, and gives out again the large amount of heat which 
had become latent when the water was vaporized, and 
from this cause alone a woolen covering feels warm during 
sweating. In the case of tightly woven cotton and linen 
fabrics, the perspiration passes through them, and evapor- 
ates from the external surface without condensation; the 
loss of heat then continues. 



280 PERSONAL HYGIENE FOR WOMEN 

In addition to this, the texture of wool is warmest from 
its poor conducting powers, and it is less easily penetrated 
by cold winds. The more readily material conducts heat, 
the cooler it feels. The property of the conduction of heat 
is in proportion to the closeness of the weave and the 
amount of air which it contains. For this reason all 
loosely woven fabrics feel warmer than closely woven ones, 
on the same principle that the more layers of clothing there 
are, the more layers of air will be retained between them. 

The recent methods of weaving cotton and linen fabrics 
more loosely have materially reduced their general defects 
as underclothing in cold weather, and if cotton or linen is 
worn next the skin it must be so woven as to give both 
thickness and porosity to the fabric. 

For the majority of people, during the wet and cold 
seasons woolen undergarments are the best. If cotton is 
worn, it must be loosely woven, so that it may entangle a 
large quantity of air within its meshes. 

The underclothing should fit tolerably closely the out- 
lines of the figure, without impeding the movements. 
Combination undersuits, which reach from the neck to the 
ankles, are the best ; the weight should be adapted to the 
season of the year, and should be changed with the 
weather, regardless of the date of the calendar. 

The great disadvantage of woolen undergarments is 
the way in which its soft fibers shrink in washing, and after 
a time become smaller, harder, and less absorbent. To 
avoid this, the greatest care must be exercised in the wash. 
Woolen fabrics are sometimes very irritating to the skin, 
in which case some of the loosely woven cotton or linen 
fabrics must be substituted. In the choice of woolen 
undergarments the touch is the best guide; there should be 
smoothness and great softness of texture. 

In very cold weather the combination undersuit worn 
in the house should be reinforced by " equestrian tights " 
for outdoor wear. These come in black and can be drawn 
on over the shoes. They are a much greater protection 
against the cold and wind than a flannel skirt, and do not 



CAUSE OF WOMAN'S PHYSICAL DETERIORATION 281 

possess the grave objection of winding about the legs in 
walking in the wind. 

Lack of proper clothing of the lower part of the body 
is beyond question one of the chief causes of the great 
prevalence of pelvic inflammation and of Bright's disease 
in women. 

But not only is there to be considered the danger of 
laying the seeds of disease from going out into the cold air 
while the body is too lightly clad, but also that, in order 
to maintain the normal temperature of the body in winter 
without the aid of warm clothing, requires a greater ex- 
penditure of nervous energy, which in turn is the equival- 
ent of a large amount of life force. It is not only impru- 
dent, but most injurious, to exhaust unnecessarily the 
powers, of the body, when mere mechanical appliances, 
like clothing, will obviate this continuous expenditure of 
vital energy. 

Another way in which clothes save the wear and tear of 
the body is by diminishing the amount of heat the system 
must produce by the oxidation of the elements of food. 
When properly clad, there is less loss to the body of its 
heat, and consequently there is less food needed to supply 
this loss. 

The Length of the Walking Skirt. — The present vogue 
of having the walking skirt five inches from the ground is 
an excellent one, as it not only considerably diminishes 
the weight of the skirt, but it interferes much less with the 
forward swing of the leg in walking, which otherwise has 
to be overcome by the muscular force of the leg. In walk- 
ing, the length of the step should be proportionate to the 
length of the limb; the leg is carried forward by the un- 
conscious swing at the hip. 

The chief exertion in walking is caused by the raising 
of the foot and leg to the point at which it goes forward 
and downward. By any artificial shortening of the step, 
such as is caused, for instance, by long skirts, it requires 
much more muscular effort to walk the same distance. 
Besides which, there is the additional friction of the skirts, 



282 PERSONAL HYGIENE FOR WOMEN 

which is increased by the slightest wind; this has been 
likened to the process of eternally walking through a field 
of long grass. 

Another most important reason for not wearing long 
dresses on the street is that they stir up the dust and col- 
lect microbes, and thus contribute materially to the dis- 
semination of the germs of disease and subject the wearer 
and her family to the risk of infection. 

The question of clothing takes an important place in 
the hygiene of the lungs. All clothing may be approved 
which is sufficiently warm, and which allows of modifica- 
tions according to the variations in the temperature, and 
does not hinder the movements of the body, and particu- 
larly those which are carried out by the respiratory muscles. 
In the first place, it is very important that the muscles 
about the shoulders should have perfect freedom of 
motion, in order that the expansion of the apices of the 
lungs should not be interfered with. Clothes which hang 
heavily on the shoulders, and especially those which grasp 
the neck tightly, are unsuitable. Special attention must 
be given to this point in the selection of winter clothing. 

In going up long flights of stairs furs and heavy top coats 
should be taken off and carried over the arm; this will 
prevent much shortness of breath and gasping when one 
reaches the top of many flights. 

The Winter Street Dress. — The street dress for winter 
should be warm enough to prevent a feeling of chilliness, 
and yet be light enough to prevent the wearer from be- 
coming overheated while walking, or from feeling a sense 
of weight of the clothing, which is always a sign of being 
too warmly clad. 

For outside coats impregnated woolen materials, water- 
proof, but at the same time porous, are the best, except 
in very heavy rains. A storm coat of some kind should 
complete the costume for rain or snow. The woman 
should never stay indoors on account of very cold or in- 
clement weather, as being housed up and the lack of suffi- 
cient exercise make one very susceptible to the very sud- 
den changes for which our climate is so notable. 



' CHAPTER IX 

PHYSICAL TRAINING THE KEY TO HEALTH AND 
BEAUTY 

The Ancient Greeks the Most Perfect Type of Beauty; the Cause 
of the Inferior Physique of American Women; the Physical Training 
of the Japanese Women; Improved Physique as the Result of 
Physical Training; Increasing Stature and Improved Physique 
of American Men; Report of the Royal Commission of Great Britain 
on Physical Training; Physical Training Among the Ancients; the 
Influence of Physical Training on the Health and Life of the Indi- 
vidual; the Effect of Exercise on Brain Development and Character; 
the Physiology and Pathology of Exercise; the Relative Proportions 
of a Perfect Female Form; Table of Standard Weights for Women; 
the Muscular System; the Benefits of Exercise; Passive Exercise; 
Massage; the Balance and Carriage of the Body; Common Defects in 
the Carriage of the Body; the Heart's Need of Exercise; the Gym- 
nasium in the Campaign against Disease; Gymnastic versus Ath- 
letic Training; Exercise after Eating; Effect of Brain Fatigue on 
Body Fatigue, and vice versa; Marks for Physical Efficiency; 
Advantages Derived from Athletic Sports; Ethical Value of Sports 
for Women; Forms of Athletic Games Best Suited to Women. 

Physical training is the key to all beauty of form and 
face as well as grace of motion. Beaut}' without health 
is inconceivable. 

The Greeks were the devotees of the beautiful, and 
they were the most perfect embodiments of health and 
beauty the world has ever seen. Their splendid physique 
was due to their outdoor life, physical training, which 
began in childhood and youth, and was systematically 
carried on throughout life, their public baths, and their 
athletics, sports and national games. Beauty is the in- 
evitable corollary of health. 

Ard the Greek artists bequeathed to all future genera- 
tions a legacy of untold value, using the men and women 
of the golden age of Greece as the prototypes for the most 

283 



284 PERSONAL HYGIENE FOR WOMAN 

beautiful statues which the world has ever seen, proving 
that through the perfect development of the muscular 
system alone can an ideal type of beauty be attained, and 
these statues also show that the women of that day were 
the physical compeers of the men. 

The greatest attention to the physical development of 
her citizens was given in Sparta. Girls and young women 
were subjected to a similar, though less severe, training 
than men and boys. It included running, leaping, wrest- 
ling, and throwing the lance; these formed the favorite 
contests in the national games. Xenophen says: "The 
Spartans are the healthiest of all the Greeks, and among 
them are found the finest men and the handsomest women 
in Greece." The women of the Teutonic tribes frequently 
accompanied their husbands to war, and exhibited in- 
tances of the most daring bravery. 

History, as well, as these magnificent legacies in marble 
and on canvas, teaches us that no greater fallacy could be 
imagined than that "we are women, and therefore weak." 
On the contrary, " We are weak, because it never entered 
into our thoughts that we might be strong," and it has 
been repeatedly proved that physical deterioration can be 
overcome by exercise, and that the same means greatly 
increases the mental capacity. 

In savage races women are the equal, if not the su- 
perior, of the men, and woman's smallness of stature, 
physical inferiority, and lessened powers of endurance 
must be attributed to the customs of civilized society 
carried on for hundreds of years. 

The Cause of the Inferior Physique of American. 
Women. — The majority of American girls and women of 
the present day have undeveloped muscles, a bad carriage, 
an impaired digestion, and are without skill in outdoor 
games, and unable to ride, row, or swim. 

From the measurements of twelve hundred boys and 
girls, Professor Sargent ascertained that at the age of 
fifteen years boys are three-quarters of an inch taller than 
girls, but that the mean height in the two sexes is the same, 



PHYSICAL TRAINING THE KEY TO HEALTH 285 

and that, taking the sum of the measurements of the head, 
chest, waist, legs, and arms, the mean total was equal in 
boys and girls. The sum of these measurements is regarded 
as indicative of the strength of the individual, but that, as 
a matter of fact, it was found that the girls did not com- 
pare favorably with the boys in point of strength. In 
capacity of lungs the girls were seventy cubic inches be- 
hind the boys, and that, in strength of the expiratory 
muscles, the weakest boy was stronger than the average 
girl. In strength of back, leg, chest, and arms, the show- 
ing of the girls was a little better, though considerably 
below what it should have been. 

At twenty years of age the man was found to be five 
inches taller and twenty pounds heavier. The superiority 
of the male in strength was now much more apparent than 
at an earlier age. He now presented ninety cubic inches 
greater lung capacity and one hundred and forty-three 
pounds, greater strength of legs, while the muscular power 
of the arms and chest was more than double that of 
woman. The charts showed that women were physically 
inferior to men in almost every particular. 

Dr. Sargent then goes on to say, "The principal char- 
acteristics of general form that distinguish civilized women 
from men are smaller muscles, sloping shoulders, broader 
hips, and shorter legs. The smaller muscles and the 
shorter legs may be said to be embryonic, while the super- 
ior breadth of the hips indicates a greater evolutionary 
advancement in this part of the body than has taken place 
in man. The constricted waist must be regarded as a 
deformity artificially produced. When the hips are large 
in the male or female , the waist will naturally be larger if 
the muscles which connect the trunk with the pelvis have 
nothing to constrict them. Since the hips of women are 
much wider than those of men, we should expect to find the 
waist proportionately larger in women than in men. 

In close antithesis to these observations of Dr. Sargent's 
on the physical inferiority of American women to men, 
it is both interesting and instructive to note those of Dr. 



286 PERSONAL HYGIENE FOR WOMEN 

Hancock in his work on "Physical Training for Women 
by Japanese Methods/ ' 

The Physical Training of the Japanese Women. — 
A Japanese woman is usually the peer of a man of her own 
race who is of the same age and height, especially when 
weights are about equal. This is due to the fact that the 
Japanese women exercise in much the same way that the 
men do, and devote fully as much time in the endeavor 
to gain strength. 

In the Japanese system of bodily training, known as 
jiu-jitsu, it is considered advisable in the initial stages to 
have boy and girl contestants as nearly equal in age and 
height as possible. The girls enter the arena upon equal 
terms with the boys, and have proved their fitness to do so. 
Grown men and women practise together; other conditions 
being equal, the women show an equal amount of strength 
with the men. 

The back of the average Anglo-Saxon woman is gener- 
ally the weakest part of her body, while the normal Jap- 
anese woman satisfies the artist's ideals as well as the 
surgeon's. The average Japanese woman of to-day shows 
a figure as perfectly molded, and of as true proportions, 
as the women of ancient Greece were able to display. 

First of all, the Japanese women are taught that life 
is impossible without a sufficient supply of fresh air. 
This internal cleansing with air is deemed of more impor- 
tance than the bath which follows soon after. That the 
Japanese woman is a deep breather is shown by the firm 
muscles that stand out on the abdomen. 

Consumption is a rare disease in Japan; even winter 
coughs are of rare occurrence. The Japanese look upon 
full, deep breathing as being the most vital function in 
life; food is not so important, although it is necessary. 
The best exercises are of little importance when the breath- 
ing which accompanies them is not properly done. 

Improved Physique as the Result of Physical Train- 
ing. — Dr. Mary Taylor Bissell, formerly the medical 
director of the New York Berkeley Ladies Athletic Club, 



PHYSICAL TRAINING THE KEY TO HEALTH 287 

and one of the pioneers in the systematic physical training 
for women, gave as the result of her experience there, 
"The gain of twelve months' exercise in the gymnasium 
is, for the chest two inches, stature two inches, and an in- 
crease of 30 per cent, in the lung capacity; many of the 
strength tests were doubled, the spine became erect and 
the arm vigorous, and the girl gained for herself the con- 
sciousness of controlling her own body instead of having 
it control her." 

Increasing Stature and Improved Physique of 
American Men. — Dr. Born's measurements of Yale 
athletes and students suggest the inference that American 
men are becoming physically greater than any other known 
race. Comparing averages in 1903 and 1908, it appears 
that Yale men are one inch and a half taller than their 
predecessors of five years ago; they are twenty-seven 
pounds heavier, broader chested, and have an increased 
lung capacity of seventy-two cubic inches. 

The measurements of Harvard students, published last 
fall by Dr. Sargent, corroborate Dr. Born's deductions, 
that American college men have larger and more vigorous 
bodies than their fathers. 

Dr. Sargent's association of vigorous brains with strong 
bodies is borne out by Professor W. T. Porter's examina- 
tion of 30,000 school-children in St. Louis in 1893, and by 
subsequent observations made by other men. 

It is the opinion of Dr. Crampton, director of physical 
training in the New York city schools, that this improved 
physique in American men, observed in the universities, 
is not in a small measure due to the fact that within the last 
five years athletics have been introduced into the public 
schools, so that there are now hundreds of teams of base- 
ball, football, basket-ball, and track athletics, where there 
was only one before, so that already the colleges are re- 
porting that the young men entering them are bigger than 
they were ten years ago. 

Professor Phillips of Amherst thinks that the young 
women are certainly one inch taller and five pounds heavier 



288 PERSONAL HYGIENE FOR WOMEN 

than they were ten years ago. This improved physique 
of Americans he attributes, like Dr. Crampton, to the fact 
that the American boy has now come in for his heritage of 
athletic sports, and he makes a strong plea for "adult 
play" — that every man and woman should have as good 
an opportunity as boys and girls to get out on an open 
space and play baseball, football, hockey, run, jump, and 
have a good time. 

To show the importance which Great Britain places 
Dn physical training for boys and girls the following 
report of the Royal Commission of that country for 1903 
is given under the caption " A National System of Physical 
Training." 

Report of Royal Commission of Great Britain on 
Physical Training. — "(1) Physical training should be 
regarded as of equal importance with mental training. 

" (2) During school life physical training is quite as 
important for girls as for boys. 

" (3) Systematic physical training is necessary both for 
country and town children. 

"The daily walk to school is exercise, but not exercise 
which develops the body as a whole, or counteracts 
the liability to stoop, to be round-shouldered, or to be 
slovenly in gait. Moreover, all children during school 
life must spend many hours with but little change of 
position, the effects of which can only be corrected by 
systematic physical exercise. 

" It should aim at the healthy development of the body, 
as well as of the mind, by the regular development of all 
the muscles, the quickening of the intelligence and 
activity, and the formation of the habits of prompt 
obedience, precision, smartness, and discipline. The 
exercises should not be for mere display or entertain- 
ment, but each should have its particular purpose and 
value to develop all parts of the body. 

"A certain amount of physical exercise once a day or 
oftener is preferable to even a greater amount, at longer 
or irregular intervals. 



PHYSICAL TRAINING THE KEY TO HEALTH 289 

" Games are very useful and ought to be encouraged, 
but they cannot be played by all children, and usually 
the weaker ones go to the wall ; that is, those most needing 
systematic development are excluded. Games affording 
opportunities for violent exercise are useful for the 
development of reserve strength, and form an admirable 
field for the cultivation of social and public spirit. We 
strongly favor their organization and development at all 
schools. 

"For boys, in addition to the regular games, country 
runs, leaping and dancing the Highland Fling; for girls, 
skipping and hockey. For both, swimming is strongly 
ad vised.' ' 

Physical Training Among the Ancients. — Greek 
culture regarded the individual as valuable in and for 
himself, and sought to promote first of all his full and 
free development. The idea was symmetry and balance 
of parts, and, to attain complete and harmonious man- 
hood, mind and body were trained together. 

Games played an important part in the life of the 
Athenians, and their importance in the education of 
children was early recognized. 

From the age of seven to sixteen it is probable that 
one-half of the day of the Athenian boy was spent in 
intellectual and the other half in physical education. 
The aim of the Athenian education was to produce men, 
independent but respectful, freedom loving but law 
abiding, healthy in mind and body, clear in thought, 
ready in action, and devoted to their families, their 
fatherland, and their gods. 

Gymnastics included everything relating to the culture 
of the body. 

The culmination of the Athenian education was danc- 
ing. As a supplement to gymnastic culture, it toned 
down the ardent exercise of the gymnasium and the over- 
energy of muscular development to the ease and grace 
which was the Athenian ideal. 

The Romans. — The early Romans possessed some traits 

19 



290 PERSONAL HYGIENE FOR WOMEN 

in common with the Spartans. They were intensely prac- 
tical and interested in those things whose usefulness was 
apparent. Education should fit a man for his work in 
the world. 

A Roman structure, quite as characteristic as the Greek 
gymnasium, was the public bath or therma, found not 
only in Rome, but in every important provincial town 
in the days of the empire. Both made provision for 
exercise and contained a system of baths, but in the 
thermae the baths occupied the greater part of the space, 
and the rooms and courts for exercise were smaller and 
fewer. 

The Influence of Physical Training on the Health 
and Life of the Individual. — If we believe, with Spencer, 
that " Education is preparation for complete living," 
we must appreciate that good carriage, bodily control, 
physical judgment, will power, and courage are an im- 
portant part of the equipment of every man and woman. 
These qualities are intimately associated with motor 
coordination, and they are best developed through 
physical training. 

The power of self-preservation, by which the individual 
is enabled to handle his body easily under all conditions, 
and so escape physical injury and death, depends upon 
physical judgment of time and distance, and the ability 
to run, jump, vault, climb, and swim. These are all 
fundamental exercises. 

The love of play and the ability to play a number of 
games contribute very largely to health and happiness. 
The play habit must be acquired in youth or it will never 
be developed. 

The best qualities of mind and character can only be 
obtained through physical experience and physical 
struggle. With stalwart physique comes a vigorous 
type of womanhood, physical courage; with flabby muscles 
there is apt to result flabby thinking and flabby acting, 
superficiality, and inefficiency. Next to hunger the most 
dominant instinct is the play instinct. 



PHYSICAL TRAINING THE KEY TO HEALTH 291 

The Effect of Exercise on Brain Development and 
Character. — The growing interest in preventive medicine, 
and the very great popularity of the opportunities afforded 
for athletic training, attest to the value which people 
are beginning to place upon health as an asset in their 
social, domestic, business, and professional lives. 

But it is not generally or sufficiently understood just 
how great is the effect of physical training on the develop- 
ment of the brain or upon the mental activities. With 
a strong, vigorous action of the heart there is a feeling of 
courage and general exaltation, whereas with a weak 
heart and enfeebled circulation, fear and impaired mental 
activity predominate. 

The manner in which the organic functions are per- 
formed not only determine the health of the body, but the 
temperament and character as well. There is a conserva- 
tion of energy in the fashioning of the will — only part 
of the energy is expended in the outward effort, while 
the rest goes to lay the foundation of a future will, so that 
exercise builds up faculty and conduct character. 

We cannot perform an act voluntarily unless we know 
what we are going to do, and we cannot know exactly 
what we are going to do until we have learned to do it. 
The very simplest movement brings about a change 
in the organic structure of the brain, and this change 
leads to more complex movements and further improve- 
ment in brain structure. Most skilled movements give 
more exercise to the central nervous system than, to the 
muscles. Movements calling for a high degree of skill, 
correlation of the different senses, sense discrimination, 
fine coordinations, and a rapid and responsible exercise 
of judgment, all tend, through the action of the association 
fibers, to a high degree of brain development. 

An essential feature of exercise is that a part of it at 
least shall afford amusement, diversion, and recreation 
to the overwearied and harassed brain. Hence, the 
necessity to introduce dancing, field sports, etc. By 
these means industrial efficiency, communal morality, 



292 PERSONAL HYGIENE FOR WOMEN 

and social consciousness are promoted. Public amuse- 
ments of a proper sort are a public necessity. 

The great menace to the city is the limited opportunities 
for healthful play, and over one-third of the population 
of the United States live in towns. The physical side of 
the question is the largest, for it involves health, and 
consequently poise and self-control. It involves a legiti- 
mate occupation of surplus energy and its wise direction, 
and it also involves companionship. 

The great object of physical training is then to secure 
the most perfect development of the body, with the 
corresponding development of the brain, so that the 
highest physical and mental efficiency of the individual 
may be attained. 

The possession of a large reserve of muscle and nerve 
force, ready to be used in any emergency, gives confidence 
to the individual, increases the spirit of taking the initia- 
tive and undertaking grave responsibilities that come 
into the life of every woman, especially those who are 
engaged in the business or professional world, and the 
building up of this necessary reserve force is one of the 
inestimable advantages of a gymnastic and athletic 
training. 

The Physiology and Pathology of Exercise. — Exer- 
cise is divided into active or voluntary and passive. 

Passive exercise does not require any exertion of the 
will power. Massage increases the local nutrition of the 
parts, stimulates the nerves, and is restful, rather than 
exhausting, to the overwrought brain and wearied nerves. 

Active exercise is further divided into exercise of 
effort and exercise of endurance. Under exercise of 
effort are classed all gymnastic feats. The primary object 
of a gymnastic training or education is to produce a 
symmetric development of the entire body, while, on 
the other hand, the training necessary to execute gym- 
nastic feats produces an overdevelopment of one part 
of the body at the expense of the rest, as is seen in the arm 
of the blacksmith and the leg of the danseuse. All 



PHYSICAL TRAINING THE KEY TO HEALTH 293 

exercises of effort, whether of strength, skill, or speed, 
demand and cultivate mental concentration, a rapid 
response of the muscle to the orders of the will, develop 
the power to accomplish complicated coordinations, 
and the knowledge of how these difficult movements 
may be performed with the least expenditure of nerve and 
muscle force. Exercising a muscle develops it up to its 
physiologic capacity, but if a muscle is habitually over- 
worked, pathologic results occur, and instead of a quick, 
sharp contraction of the muscle, the contractions will be 
weak and uncertain, and, if carried too far, the muscle 
may eventually atrophy from overwork. 

Exercises of endurance include walking, running, swim- 
ming, and rowing — the range of movement in these is much 
more limited than in exercises of effort. In these, each 
movement is well within the individual's powers, yet, by 
increasing the rapidity of the movements, or by their 
prolonged continuance, the total amount of muscular 
work accomplished may be very great. Normally, the 
contraction and relaxation of the muscles are compara- 
tively slow, so that the poisonous waste matter produc- 
ing fatigue is continually being removed from the tissues, 
and not allowed to accumulate; whereas, in exercises 
of effort, there is no time allowed for the scavengers 
to work, and fatigue of the most active muscles sets in 
rapidly. 

Fatigue may appear in several forms, depending on the 
character of the exercise which produced it. When the 
exercise is sufficiently active, the amount of waste matter 
thrown into the circulation is greater than can be elimin- 
ated by the lungs; breathlessness and palpitation of the 
heart result; so soon as the equilibrium between waste 
production and elimination is established, the individual 
is said to have gotten his second wind. Or, again, a slow 
pace, too long kept up, will produce exhaustion, so that the 
products of tissue waste accumulate, the beat of the heart 
is fast, irregular and weak, the nervous system becomes 
stupefied, and the muscles fail to respond to the normal 



294 PERSONAL HYGIENE FOR WOMEN 

physiologic stimulus. This is a form of fatigue not in- 
frequently found among zealous housewives, in which the 
demands made upon the nervous system by continual and 
carking family cares, added to the very strenuous work of 
the household, exhausts both nervous and muscular sys- 
tems. 

Recovery from this form of fatigue takes a much longer 
time than the preceding. The individual is too tired to 
sleep, the night is troubled by disturbed dreams, there is 
a soreness and stiffness of the muscles and joints which 
remain for some days. There may be an actual rise in 
temperature, and the urine passed has a high specific 
gravity, with sometimes even albumin. 

If, now, this overwork is continued over prolonged per- 
iods of time, without allowing sufficient time for the neces- 
sary recuperation, there follows a slow and profound ex- 
haustion, which is much more difficult to overcome. In 
this condition the temperature becomes subnormal, the 
weight decreases, the skin and muscles become flabby, and 
the skin is pale, the eyes are dull and listless, and the indi- 
vidual is without ambition to rouse herself from her 
lethargy. 

During a contraction each muscle-cell shortens and 
thickens, giving off some of its substance into the lymph- 
space which surrounds it, and absorbing food, consisting of 
carbohydrates and oxygen, from the surrounding plasma. 
Exercise improves nutrition by the rhythmic, automatic 
massage caused by the contraction and relaxation of the 
muscles on the vessels which they contain, while warmth 
favors the elimination of waste matter. 

It has been proved by Hawk, of the University of Penn- 
sylvania, in his experiments on the blood-count of an 
athlete in training, that various forms of active muscular 
exercise produce an average increase of 16.8 per cent, 
in the number of red corpuscles. When exercise is long- 
continued, the rate of increase lessens, and, further, the 
number may be decreased in greatly prolonged violent 
exercise. The explanation of this is that a large number 



PHYSICAL TKAINING THE KEY TO HEALTH 295 

of cells lie inactive in various tissues of the body until 
they are brought into the circulation by muscular exer- 
cise. 

Athletic training has been called " mainly heart train- 
ing." Exercises of endurance do not require supreme 
efforts, but they do accelerate the action of the heart and 
lungs, and the aggregate of work done is very much greater 
than in exercises of strength, but the exercise must be 
sufficiently active to provide for the free circulation of 
lymph, which is carried on mainly through the massage of 
muscular contraction. 

If a walk be so listless that there is not sufficient move- 
ment of the muscles to overcome the pernicious influence 
of gravity acting on the column of blood contained in the 
veins of the abdomen, thighs, and legs, the vessel-walls 
may become permanently overstretched and varicose. 
The exercise must be sufficiently active for the muscular 
contractions to empty the lymph-spaces and hasten the 
circulation. It usually raises the general bodily, as well 
as the local, temperature of the parts, and so facilitates the 
removal of the waste-products. 

The acquirement of skill lies in the training of the nerve 
rather than the muscle. A simple movement requires 
only a nerve impulse to the acting muscle, while a com- 
plicated movement requires a wave of impulses to the 
accessory and antagonistic groups of muscles which control 
and steady the movement. It is easy to see how, in the 
first efforts to perform complicated movements, the con- 
tractions of the muscles will be jerky and inaccurate, 
many useless muscles will be employed, and the expendi- 
ture of nervous energy will be out of all proportion to the 
result, and these first attempts at new feats of skill rapidly 
exhaust the attention. This is well illustrated in the first 
efforts of a child learning to walk. 

Exercises of strength and skill train that alertness of 
mind so essential in ordinary life. They shorten the period 
between thought and action, producing what is known as 
"presence of mind." 



296 PERSONAL HYGIENE FOR WOMEN 

The Relative Proportions of a Perfect Female 
Form. — The relative proportions of a perfect female form, 
as deduced by modern sculptors from the Greek statues, 
are as follows: With a height of five feet five inches, the 
weight should be one hundred and thirty-eight pounds. 
The woman should, with the arms extended, measure 
from tip to tip of the middle finger, five feet five inches; 
that is, exactly her own height. The length of the hand 
should be one-tenth, the foot one-seventh, and the di- 
ameter of the chest one-fifth that of the height. The 
distance from the perineum to the ground should meas- 
ure the same as from the perineum to the top of the 
head. The knee should be exactly midway between the 
perineum and the heel. The distance from the elbow 
to the little finger should be the same as the distance from 
the elbow to the middle of the chest. The measurement 
from the top of the head to the chin should be the same as 
the length of the foot, and there should be the same dis- 
tance between the chin and the armpits. A woman of this 
height should measure twenty-nine inches around the waist, 
thirty-four inches around the bust, if taken under the arms, 
and forty-three inches if measured over them. The upper 
arm should measure thirteen inches and the wrist six inches. . 
The calf of the leg should measure fourteen and one-half 
inches, the thigh twenty-five inches, and the ankle eight 
inches. 

The table on page 297, compiled by Dr. Weisse, the Med- 
ical Statistician of the New York Life Insurance Company, 
"A Table of Standard Weights for Women," is based on 
the average weights of over 58,000 insured women, and is 
given to show the normal relation between the height and 
weight. A point of extreme interest in the table, and one 
that is not generally recognized, is the variation in weight, 
independent of the height, at different ages. 



PLATE IV 




Juno. 



PLATE V 




Venus de Capua. 



PHYSICAL TRAINING THE KEY TO HEALTH 



297 



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298 PERSONAL HYGIENE FOR WOMEN 

Dr. Weisse found the average height of women to be five 
feet four inches, and the average weight one hundred and 
thirty-three pounds, and that the average male height was 
three inches greater than that of the female. 

Women should range in weight from one and eight-tenths 
to two and two-thirds pounds to each inch in height. In 
order to determine your own factor in this respect divide 
your weight in pounds by your height in inches. Any 
weight above two and one-half pounds to the inch in 
stature may be considered as excessive, inasmuch as it adds 
nothing to one's mental or physical efficiency, and is fre- 
quently the forerunner of obesity, the remedy for which 
is to live on a selected diet and to burn up more through 
exercise. 

In an ideal condition there is a sufficient quantity of 
fat to give a pleasing rotundity of outline. In women 
the tendency is for fat to accumulate, especially after 
forty years of age, about the waist, abdomen, and upper 
part of the thighs. In addition to the unsightliness 
which this gives to the figure, it is often the indication 
of the fatty degeneration of the muscles, and the heart 
is liable to become involved, and fatty degeneration of 
the heart is one of the frequent causes of death. The 
lack of use of the muscles in these regions of the body, 
which is caused by wearing corsets, is the reason for the 
accumulation of fat here. It can be reduced by the 
proper exercises and regulated diet. 

The Muscular System. — The bony skeleton forms 
simply the framework of the body, and, while it determines 
the general outlines and height for the most part, the 
weight and general size of the body depend upon the 
muscular development and the amount of adipose tissue. 
The bones are not only padded about with muscles, but 
the muscles are inserted into the bony sheaths in such a 
way that a development of the muscles causes a develop- 
ment of the bones as well. Again, the stature is increased 
by the erect position of the spinal column, and this can 
only be attained by great strength of the muscles which 



PLATE VI 




Venus de Medici. 



PLATE VII 




Venus de Milo. 



PHYSICAL TRAINING THE KEY TO HEALTH 



299 



hold the spine erect. The inequalities of the muscles are 
filled out with adipose tissue, giving a pleasing contour 
to the face and figure. 

There are some five hundred muscles in the human 
body; these muscles vary in size and form, according to 




Fig. 21.— The skeleton (Lewis). 

their situations in the body and the functions which they 
are called on to perform. 

Nearly all the muscles in the body are arranged in 
two different or antagonistic sets, and are placed on the 
opposite sides of the part, so that in acting — that is, by 



300 



PERSONAL HYGIENE FOR WOMEN 



their contractions or shortening — they move the limb 
in opposite directions, and it is by the alternate contrac- 
tion, or shortening and relaxation of the two sets of 
muscles, that the movements of the body are accomplished. 
The muscles which bend the joints are called flexors, 
while those that extend the joints are called extensors, 
so that in order to perform their work, which is that of 
contraction, the muscles must exert enough force to 
elongate the opposing muscles, overcome the tonicity 
of the antagonizing muscles, and lift the weight of that 
portion of the limb into which they are inserted. It is 




Fig. 22. — Muscular fibers, 
highly magnified. 




W 



Fig. 23. — Different directions of 
fibers in the three layers of abdom- 
inal muscles. 



by the action of the muscles that the body is held 
upright. 

Action of the Muscles of the Abdomen. — The trunk is 
maintained from falling backward by the action of those 
huge muscles on its anterior surface. The space between 
the pelvis and the thorax is called the abdominal cavity. 
Its walls are almost wholly composed of muscles. There 
are several important facts to be noted about these 
muscles. First, that they extend from the brim of the 
pelvis, into which they are inserted, to the ribs and breast 
bone, to which the other ends of these muscles are attached; 



PHYSICAL TRAINING THE KEY TO HEALTH 301 

that there are three layers of these muscles; and, lastly, 
that the fibers of the different layers run in different 
directions, so that they cross each other, as shown in the 
figure. The reenforcement of the layers, the arrange- 
ment of their fibers, and the manner in which they dove- 




Fig. 24. — Muscles of the anterior surface of the trunk (left side, 
superficial; right side, deep). 

tail into the adjacent groups of fibers give a structure of 
the greatest possible strength. 

Action of the Muscles of the Back. — The trunk is kept 
from falling forward by the action of the muscles of the 
back. These are arranged in six layers. The cut shows 
the direction of the fibers. The first, or outside layer, 
consists of the trapezius and latissimus dorsi, or, in other 



302. 



PERSONAL HYGIENE FOR WOMEN 



words, the broad muscle of the back. On the one side 
these muscles are attached to the spines of the vertebrae; 
the sharp ridge which is felt in the middle of the back, 
and the broad attachment to the pelvis afford a firm base 
of support. There are other muscles which run parallel 




Fig. 25. — Muscles of the posterior surface of the trunk (left side, 
superficial; right side, deep). 

with the spinal column, whose function it is to hold the 
spinal column erect. 

Standing erect calls into action almost all the muscles 
of the lower extremities, trunk, and neck. So long as 
the line of gravity falls within the line of the feet, the 
muscular effort required is so slight that it is little more 
than the tonicity contained in all living muscle. The 



PHYSICAL TRAINING THE KEY TO HEALTH 303 

greater the displacement of the line of gravity, the greater 
the muscular effort required to maintain the equilibrium 
of the body. 

Muscular Energy. — The muscles of the body, even when 
at rest, are under a slight degree of tension. When stimu- 
lated, the muscle contracts — that is, it becomes shorter 
and thicker. A muscle can only remain in a state of 
contraction for a few seconds, because the force of the 
muscular fibers is more or less exhausted during contrac- 
tion. The more rapid the contractions, the sooner does 
fatigue manifest itself. 

Like the steam engine, the muscles of the body, in 
performing their work, produce heat and motion. The 
fuel which supplies this force is taken into the body in 
the shape of food; it is prepared for use in the intestinal 
tract, and from there carried by the blood, to be stored 
up in the muscles and various tissues as latent force. 
The muscles contain one-fourth of all the blood in the 
body. h 

Heat Production. — By watching a muscle when con- 
tracting, we see that there is not only a change of shape, 
but a dilatation of its blood-vessels, that is, more blood 
passes through a muscle when it is contracting than 
when it is at rest, and this increased flow continues for 
some little time after the contraction has ceased; there 
is also a rise of temperature. Nearly three-fourths of the 
heat developed in the body is produced in the muscles 
at the actual moment of muscular contraction. Hence, 
we learn that the whole body is heated by muscular 
exercise; the even temperature of the various parts is 
maintained through the circulation of the blood. This 
combustion, going on throughout the entire economy, 
is the source of all force or energy in the body. In every 
movement, every breath taken, in the change even of a 
muscle of expression or the conception of a passing fancy, 
combustion has occurred and potential force has been 
liberated. 

Muscular Fatigue. — The fatigue produced by muscular 



304 PERSONAL HYGIENE FOR WOMEN 

contraction may be due to the consumption of the readily 
available material present in the muscle, to the consump- 
tion of the supply of oxygen, or to the presence of the 
products of combustion, and, if Weichardt's theory is 
correct, to these must be added the presence of a definite 
"fatigue toxin." 

During repose the internal changes of the tissue manu- 
facture new explosive material out of the comparatively 
raw material already present in the fiber, and the directly 
hurtful products of the act of combustion are either carried 
off, or undergo changes by which they are converted into 
comparatively inert bodies. A stream of fresh blood 
may exert its restorative influence, not only by quickening 
both of these events, but also by carrying off the immediate 
waste-products, while, at the same time, it brings new raw 
material. 

Every movement of the body depends as much upon 
the proper coordination of the muscles for its accuracy, 
grace, and force as upon the strength of their contraction, 
and while the fatigue, of which we are conscious in our own 
bodies after prolonged or unusual exertion, arises partly 
from the exhaustion of the motor nerves, it is chiefly 
from the exhaustion of the central nervous system con- 
cerned in the production of voluntary impulses. A man 
who feels absolutely exhausted may, under excitement, 
perform a very large amount of work with his already 
wearied muscles. The will rarely, if ever, calls forth 
the greatest amount of contraction of which the muscle 
is capable. 

Passive Exercise : Massage. — Massage has been de- 
fined as the systematic manipulation of the surface of the 
body by the hands of the operator in movements of strok- 
ing, pinching, kneading, and striking. The passive move- 
ments consist of flexions, extensions, rotations, and other 
movements of joints and limbs by an operator or machine 
without the cooperation or resistance of the patient. 

Massage takes the place of voluntary muscular move- 
ment, in promoting the flow of lymph and the flow of 



PHYSICAL TRAINING THE KEY TO HEALTH 305 

venous blood toward the heart, if the proper direction, 
that of rubbing toward the heart, be followed; while, 
on the contrary, rubbing down a limb or from the heart 
actually retards the process which it is meant to facilitate. 
Gentle rubbing of any part of the body promotes growth, 
while vigorous rubbing removes superfluous fat. 

Massage finds its widest field of usefulness in conditions 
of fatigue, where the elimination of waste matter must be 
assisted, and where the nutrition of a part is impaired or 
destroyed. Muscles can be improved in size, tone, and 
nutrition; ligaments can be stretched and lengthened, 
the general circulation accelerated, and overloaded veins 
made to disgorge their blood. The digestive tract can be 
stimulated, and overwrought nerves soothed and relieved 
of their hypersensibility. 

The nourishment of the muscle-cell is improved by forc- 
ing out the products of fatigue and keeping it bathed in a 
constantly renewed stream of arterial blood. This alone 
is sufficient to prevent wasting of substance in conditions 
where active movements are impossible. 

Massage relieves the nervous system by maintaining the 
nutrition of the muscles, without the expenditure of nerve 
force required to make them contract. It acts on the 
central nervous system through the nerves of sense, stimu- 
lating or soothing them, according to the nature and the 
amount of the manipulation. 

Mosso and Maggiora, of Turin, have proved, by their 
experiments as to the effect of massage on the muscles, 
that muscles were capable of doing twice as much work 
after massage. It was also discovered that extending of the 
period of the massage did not produce any greater results 
in the capacity for work; the full effect was obtained in 
five minutes. 

The action of massage in improving muscle tone, in 
postponing the onset of fatigue, and hastening recovery 
from it has long been recognized by athletic trainers. 
After a hard race or other contest, it is a matter of knowl- 
edge among trainers that a five minutes' treatment will 
20 



306 PERSONAL HYGIENE FOR WOMEN 

enable an athlete to repeat or continue a performance 
otherwise impossible. 

Massage is the most economic form of exercise on the 
nervous system. Its potency is shown by the increase of 
the red-blood corpuscles and hemoglobin, and by the in- 
creased rate and force of the heart's beat without a corres- 
ponding change in the arterial tension. It accomplishes 
these results by decreasing the resistance in the peripheral 
vessels, by the removal of the products of oxidation, and 
by mechanically moving the blood-current forward in the 
lymph-spaces and venous channels. It is thus shown to 
stimulate the circulation, the respiration, nutrition, and 
excretion. 

Mezger describes four principal manipulations: First, 
stroking or effleurage, in which the hand is passed lightly 
over the skin, with the pressure from the periphery to the 
center, following the course of the venous circulation, and 
the long direction of the muscles from their insertion to 
their origin. It may be performed by stroking with the 
palm of one or both hands, with the thumb or tips of the 
ringers. The two hands are used upon the large fleshy 
parts of the thighs and buttocks, the back, chest, and 
neck. 

Second, Friction. — This is a deep circular movement, per- 
formed with the thumbs and tips of the ringers, or by one 
hand open or clenched. The products of fatigue collect- 
ing in deep muscular tissues are thus thrown into the cir- 
culation, the gentle manipulations of stroking carrying 
them into the superficial veins. The friction should pro- 
ceed in the same direction as the stroking movements. 

Third, petrissage, also described as pinching and 
grasping, is performed by picking up the skin and subcu- 
taneous tissues between the thumb and fingers, and manip- 
ulating it with an amount of force not sufficient to cause 
pain. In this procedure the skin moves with the hand of 
the operator, and the underlying structures are thus 
massaged by it under the pressure of the fingers. The 
thumb and ringers are used to reach the individual muscles 



PHYSICAL TRAINING THE KEY TO HEALTH 307 

and small groups. The movements should proceed from 
the periphery toward the center. It is used to improve 
muscular nutrition in case of fatigue, in atrophy, in obesity, 
and other forms of muscular degeneration. 

Fourth, Striking, Tapotement, or Percussion. — Other 
names are clapping, beating, knocking, or hacking. It 
has a stimulating action on the skin, superficial nerves, 
and vessels. Hacking is performed by the ulnar border 
of the hand, and is used along the nerve-trunks. 

Fifth, Shaking or Vibration. — Shaking involves move- 
ments of the whole body or region to be treated, while 
vibration is a lesser motion in which the body or region 
remains at rest, while the surface and the structures im- 
mediately beneath it are affected. 

General massage is best given at an hour midway between 
meals, and never immediately after eating. The parts are 
at first lubricated with cocoa-butter or vaselin, to avoid 
the irritation which may follow the friction of the surface. 

The first process of massage is the simple stroking to 
empty out the lymph-channels; the next process is directed 
to the deeper tissues. This is deep kneading, and skill is 
particularly required here. As the result of this, the 
muscles are toned up and the nerves are soothed, so that 
the total effect is that of sedation, and is followed by the 
removal of the fatigue toxins, so that if necessary it will 
be possible to undertake work after the massage that would 
have been impossible before. 

The operator starts with the feet. After both surfaces 
of the foot have been well covered, the foot is firmly grasped 
and all the natural movements of the toes and ankles are 
gone through with. Next the region of the ankle, the leg, 
which is treated by circular friction by the fingers, by 
deep grasping of the areolar tissues, and, last, by deep 
pinching of the larger muscle masses. At brief intervals 
upward stroking is given from the ankle to the knee, to 
favor the venous flow of blood-currents. The same proc- 
ess is gone through with in the case of the hands and arms. 
Especial care is next given to the muscles of the loins, back, 



308' PERSONAL HYGIENE FOR WOMEN 

and neck. The abdomen is then treated. Massage of 
this region concludes with deep kneading by the heel of 
the hand in the direction of the colon. The chest is manip- 
ulated upward, from the sternum along the line of the 
pectoral muscles. The face is not usually treated in 
general massage, but the sides of the neck are stroked from 
above downward, along the course of the internal jugular 
veins. Each part operated upon should be carefully 
covered as soon as finished. 

There is a constant rise of temperature after the treat- 
ment, and there should be a rapid improvement in the 
tone and reaction of the whole muscular system. 

The usual fault in giving massage is that too much is 
given at one time; the maximum effect on a part is ob- 
tained in five minutes. Another mistake is to employ too 
heavy a hand. A patient should never feel bruised or ex- 
hausted after the treatment; there should be simply a 
pleasant lassitude and feeling of drowsiness. 

While massage is not essential for the health, it aids 
materially in maintaining good health, but, in order to be 
efficient, a skilful masseuse is necessary, as a considerable 
amount of manipulative skill is essential, which can only 
be acquired by proper training. Massage, especially 
when taken in connection with the Turkish bath, is most 
valuable to remove weariness of nerves and muscles, as 
well as slight aches and pains. 

The Balance and Carriage of the Body. — The erect 
position of the body is maintained through the exertion 
or more or less muscular force. The base of the erect 
human body is the soles of the feet; the smaller the base, 
the more danger of a fall. The base is the smallest when 
one stands on the toes. 

The way in which the spinal column is carried by the 
pelvis determines the way in which the whole body is 
carried. An erect and graceful carriage in standing and 
walking is not only desirable from an esthetic point of 
view, but it is most essential to good health. Without a 
proper development of the chest, it is impossible to secure 



PHYSICAL TRAINING THE KEY TO HEALTH 309 

a normal development of the lungs and vigor of the 
heart. 

It is upon the erectness, suppleness, and strength of the 
spinal column that most of the power and grace of the 
body depend. In the proper carriage the natural lines 
of the spinal column form a graceful and undulating line, 
and the body stands erect without any particular effort. 

The curves of the spinal column are of great value in 
protecting the brain, as they weaken the force of any 
shock, which may be caused by striking the bones of the 
feet. 

Common Defects in the Carriage of the Body. — 
Owing to the common faulty position of school children 
at their desks, the sedentary occupations of women, and 
their lack of physical training curvature of the spine is 
very common. A stooping carriage is the most common. 
The head is bent forward, the chest is sunken, the back is 
round, the shoulder-blades hang outward, the inner edges 
standing out like wings, and the abdomen is protuberant. 
The muscles are poorly developed and are weak and 
flabby. 

This stooping carriage interferes with the freedom in 
breathing, and prevents the proper development of the 
upper part of the chest and lungs. Hence, it predisposes to 
lung diseases and tuberculosis, a weak heart, poor circu- 
lation, shortness of breath, inability to take proper exer- 
cise, and thinness of the blood (anemia). 

Spinal Curvatures. — The spinal column is normally 
directly in the middle of the back; any deviation of this 
column to either side is abnormal, and the lungs become 
cramped in a small and non-distensible bony cage. This 
spinal curvature is most apt to take place in young girls 
or in adult women after a severe illness, when the muscles 
of the back have become particularly flabby, and, while 
still in this condition, improper attitudes are assumed at 
the desk or other sedentary occupations. 

Preventive measures are of the utmost importance. 
First of all, comes the general strengthening of the body, 



310 PERSONAL HYGIENE FOR WOMEN 

and of the muscles and bones in particular, by plenty of 
exercise in the open air. 

The habitual attitude at the desk and work should al- 
ways be carefully observed, and in all sedentary occupa- 
tions the work should be frequently interrupted to take 
systematic breathing exercises before an open window. 

Where spinal curvature has actually taken place, es- 
pecial exercises must be taken under the supervision of a 
physician and instructor. Gymnastic exercises must be 
supplemented by outdoor games and sports. 

The Heart's Need of Exercise. — The first essential for 
the maintenance of health, capacity for work, and power 
of resistance of disease is a normally developed and strong 
heart. First, there must be secured a vigorous circulation 
of the blood, and the two greatest helps to this are exercise 
and deep breathing. In the sedentary posture the heart 
works at a disadvantage. 

For the young, exercise of the heart is the chief object 
of physical exercises; this object is best attained by ex- 
ercises of speed, especially in the form of games which 
require rapid movement. In youth the recuperative 
powers of the heart and lungs are at the highest. 

An adult cannot race and scamper about like a child 
who plays for hours together, and a disturbance of the 
heart's action brought about by strenuous exercise to the 
point of fatigue of the heart is not so quickly compensated. 
On the other hand, severe exercises of strength and endur- 
ance are not so apt to prove injurious after the completion 
of growth as they are in the growing youth. Up to the 
age of eighteen years no feats of strength or of endurance 
should be attempted. From eighteen to thirty years is 
the period of life when any kind of athletic exercise can be 
taken, not only without any injurious, but with beneficial, 
results. After the period of youth new conditions begin 
to make themselves felt, and more care must be exercised 
in the demands made upon the heart. In some persons 
obesity sets in before they have reached thirty and im- 
pedes the action of the heart. About the fortieth year the 



PHYSICAL TRAINING THE KEY TO HEALTH 311 

walls of the arteries begin to lose their elasticity, they 
become more rigid, and chalk salts are deposited in them. 
Golf and lawn-tennis are now excellent. 

And now it is most essential that exercise be kept up; 
the heart must still be trained and practised. The fibers 
of every muscle degenerates when their work is reduced to 
a minimum. 

Proper health without proper breathing is a physical 
impossibility. It is necessary that those portions of the 
lungs which do take part in ordinary breathing, and 
which would atrophy from lack of use, should be fully 
developed and kept ready for suitable exercise. As soon 
as the lungs grow weary and the power of breathing is 
exhausted, the most powerful muscles of the body give 
way. The pleasure of vigorous walking, especially in 
mountainous places, is alone for her who can respond 
easily and readily to the enormously increased demands on 
the power of the respiration. 

The direct result of exercise is an increased demand for 
oxygen by the tissues, and, to meet this demand, respira- 
tion is deepened and quickened, and the beat of the heart 
is more rapid and more forcible. But the phenomena of 
increased breathing power and increased heart action 
benefit other parts of the body. At the commencement 
of an exercise the contraction of the voluntary muscles 
called into action compresses the blood-vessels, and im- 
pels the venous blood actively toward the heart, which, 
thus stimulated, contracts vigorously, and propels the 
blood in increased quantity toward the lungs. Stimulated 
by the pressure of a large amount of venous blood, the in- 
spiratory muscles contract and elevate the bony structure 
of the chest, the diaphragm pushes down the abdominal 
contents, and the air rushes in to fill the vacuum thus 
produced and to supply the oxygen necessary for the puri- 
fication of the blood. Supplied with this fife-giving 
element, the blood is returned to the heart, to be distrib- 
uted again throughout the system, and to restore the loss 
incurred in the original muscular movements. 



312 PERSONAL HYGIENE FOR WOMEN 

In this manner are not only the voluntary muscles en- 
larged and strengthened, but also the involuntary muscles, 
particularly the heart and the diaphragm. The increased 
activity of the circulation stimulates other organs to in- 
creased activity. The quantity of perspiration from the 
skin is more than doubled, the appetite is increased, diges- 
tion is more perfect, absorption is more rapid, the hepatic 
circulation is more active, and the abdominal circulation is 
carried on more vigorously. 

But, on the other hand, actual harm may be done if 
any one who has been accustomed to lead a sedentary life, 
or who is not vigorous, suddenly engages in the more 
violent forms of exercise. In this extreme exertion the 
heart may be embarrassed by the respiratory action. 
At the end of deep inspiration the increased pressure of the 
lungs impedes the flow of blood from the right side of the 
heart, while the compression of the heart itself by the 
distended lungs tends to overfill the large veins, and to 
further endanger the right side of the heart. 

During general muscular contraction the arterial pres- 
sure is increased at the outset of exertion, before the 
arteries have become relaxed, and this in turn may lead 
to the engorgement of the left side of the heart and the 
circulation through the lungs. To these conditions may 
be added still another; that is, the exhaustion of the 
respiratory muscles, partly because of the unusual amount 
of labor thrown upon them, and partly from the inade- 
quate supply of properly oxygenated blood. If the dis- 
turbance of the pulmonocardiac equilibrium be severe 
and the condition unrelieved, general prostration ensues 
long before the muscles engaged in the work are exhausted. 
If, on the other hand, the equilibrium be restored, or when 
the heart and lungs have been trained to accomplish the 
restitution, the distress disappears, and the individual is 
said to have gotten his second wind. 

The Gymnasium in the Campaign against Disease. 
— Women, generally speaking, do not take sufficient exer- 
cise. The trend of the present day is for girls of the richer 



PHYSICAL TRAINING THE KEY TO HEALTH 313 

classes to lead an outdoor life, but the women of the 
middle and lower classes do not obtain enough variety 
of exercise or enough fresh air, and to the lack of proper 
outdoor exercise is due their anemic condition, pallor, 
flabby muscles, and generally ill-nourished appearance. 

With the division of labor and the increase of wealth it 
has become possible for a large proportion of the com- 
munity to live without much all-round mental or physical 
activity. As a consequence, there are faulty circulation and 
defective nutrition, the vital resistance of the body is 
lowered, and some of its various organs or tissues are ever 
ready to take on disease. The lowering of the tone of the 
body through dissipation, want of fresh air and sunshine, 
insufficient sleep, lack of proper occupation or recreation, 
also increases the susceptibility of the body to disease. 

Senile decay is by no means only a matter of years, but 
the manner of life led. And very many people over forty 
years of age fall into a condition of senile decay, merely 
because they do not take a sufficient amount of active ex- 
ercise. In consequence the joints stiffen, the muscles 
relax, and the arteries harden prematurely. The prime of 
life would be very greatly extended, and old age delayed, 
if women only continued their active interest in work and 
systematically kept up gymnastic exercises and outdoor 
sports. 

For all classes of women provision must be made, and 
sufficient time afforded, to be devoted to some form of 
mental and physical recuperation and systematic physical 
training. 

Gymnastic versus Athletic Training. — The actual 
experience of the past few decades has proved that the 
most effective way of developing the mental and physical 
powers and the constitutional vigor is through a judicious 
system of gymnastics, athletics, and carefully supervised 
plays, sports, and games. 

To show which of the two contestants was the "better 
man" was the primary object of all contests, and this is 
the fundamental source of the love of games and athletics. 



314 PERSONAL HYGIENE FOR WOMEN 

England has relied for her physical training upon a large 
variety of games and sports, instead of an elaborate system 
of gymnastics. The Englishwomen live an outdoor life, 
are great walkers, horseback riders, and go in for athletics 
and sports, and we find that the English women have a 
much more vigorous physique and healthy and ruddy ap- 
pearance than their American sisters. 

In Norway, Sweden, Denmark, Finland, France, Ger- 
many, and Italy more stress is laid on the gymnastic 
training, and in the Olympic contests, held in London in 
1908, the twenty-five women from Denmark afforded a 
revelation to many of the Americans present. 

Medical gymnastics had their origin in Sweden, and are 
practised largely in that country and on the Continent. 

In gymnastic exercises the work done on each piece of 
apparatus must be tried repeatedly, in order to be learned, 
and then must be practised assiduously,- in order to be 
well performed. This is what makes gymnastics so valu- 
able as a means of physical training and development. 
The first essential is to learn to handle one's own weight, 
and to have the muscles of the body under complete con- 
trol, and much of the interest and fascination found in 
practising heavy gymnastics come from this acquired 
power over one's own body, and the ability to make it do 
the feats and stunts which one desires it to do. This is 
one reason why children love to climb fences, trees, etc., 
and test their ability to handle and master themselves in 
new and untried situations. 

But, in order that good and not actual harm may be 
done, gymnastics must be carried on under medical super- 
vision. Bodily exercises should, as far as possible, occupy 
the mind at the same time. The fact that gymnastic train- 
ing is being taken up in our high-schools and colleges for 
girls is a great gain, not only to the individual, but to the 
race as well. 

The proper development of the body, the clear skin and 
eye, the upright and graceful carriage, the free swing of 
the body and limbs when they move, give happiness to 



PHYSICAL TRAINING THE KEY TO HEALTH 315 

the possessor as well as to the onlookers. The esthetic 
advantages of health are very considerable. 

Among the mental and moral advantages to be derived 
from the practice of exercises and games are a greater 
amount of self-control, persistence, regularity, prompt- 
ness, and of general self-confidence. In the playing of 
games there is opportunity for originality as well as for 
observation. The unwritten code of honor, the need of 
accuracy — all these qualities are essential for a successful 
and happy issue in the great battle of life. 

The ideal physical training requires that systematic 
gymnastic exercises should be supplemented by outdoor 
games and sports. Gymnastics are not sufficient for an 
all-round means of development, because the movements 
are too regular, too expected, and too deliberate, but 
they are invaluable for health and physical development, 
for the correction of physical deformities, as a foundation 
for many games and sports, and for supplementing the 
same. Many games are so one-sided that gymnastic ex- 
ercises are essential to prevent the body from becoming 
unsymmetrically developed, and, further, gymnastic ex- 
ercises must invariably be the foundation for all games; 
no games can do what they are really capable of doing 
without the firm foundation of the best gymnastic train- 
ing. 

Those exercises and games should be selected which are 
the most fundamental and the most healthy, which will 
cause the all-round development of the body, the muscles, 
heart, lungs, chest, a good condition of the blood, good 
circulation, breathing, digestion, and the getting rid of 
the waste-products. 

Such exercises should teach obedience to law, self-con- 
trol, regularity, promptitude, and readiness to meet fresh 
conditions or emergencies, persistence, pluck, and the 
ready cooperation of nerves and muscles. 

The aim of gymnastic exercises should be to secure a 
symmetric development of all the muscles the body, 
to correct one-sidedness, spinal curvatures, and other 



316 PERSONAL HYGIENE FOR WOMEN 

physical defects, and to strengthen all the muscles of the 
body. In the gymnasium especial attention must always 
be given to the development and strengthening of the 
muscles of the back and chest, as these are the ones that 
are apt to be the most poorly developed in women, since 
they are less called into play in walking, which is the only 
exercise that most women take, and on their good develop- 
ment and strength depend the upright carriage of the 
body, a good chest capacity, and, hence, good respiratory 
capacity, a vigorous heart, and good circulation. 

Exercise after Eating. — Severe mental and vigorous 
bodily exercise immediately after a meal retards gastric 
digestion. The entrance of food into the stomach excites 
the free flow of gastric juice, which, like all the secreting 
processes, is dependent upon a flux of blood to the secret- 
ing glands. Other parts of the body, notably the brain, 
suffer from temporary anemia, and hence the great ten- 
dency to drowsiness after eating a hearty meal. At such 
a time severe mental work or vigorous bodily exercise must 
necessarily cause a corresponding withdrawal of blood 
from the alimentary canal to the brain, or, in the case of 
physical labor, to the extremities, in order to furnish the 
amount of blood necessary for the proper performance of 
the functions of these parts. The withdrawal of blood 
from the digestive organs has the effect of inhibiting gastric 
digestion, since there has been an interruption of a free 
flow of gastric juice. 

We are safe then in believing that digestion is favored 
by rest of the stomach before eating, by gentle exercise 
of the mind and body after eating, and by an undisturbed 
mental condition. 

An athletic training is productive of a more complete 
oxidation of the nitrogenous materials of the body, and, 
therefore, of a more economic utilization of these sub- 
stances. In those cases in which there is lack of physical 
training, sudden muscular exertion is followed by a waste 
of nitrogenous matter. 

The Effect of Brain Fatigue on Body Fatigue and 



PHYSICAL TRAINING THE KEY TO HEALTH 317 

Vice Versa. — Brain fatigue makes the sense of touch less 
delicate. Similarly, muscle fatigue affects brain power; 
severe muscular exertion may bring a disinclination and 
incapacity for brain work. Hard exercise uses up nerve 
force, and also causes the circulation of waste-products in 
the blood, and so the action of the brain is hindered. On 
the other hand, many people who do a great deal of brain 
work know that an early morning walk, a pull on the river, 
is most refreshing and stimulating, and actually makes 
them more capable of doing good brain work; that is, if 
they are in fair training and do not take enough exercise 
to make them tired. 

It is beyond question that a dull gymnastic drill, com- 
ing after hours of hard school work, may be a very heavy 
tax on the brain and nerves, and can hardly be a relaxa- 
tion. Outdoor exercises, which require practically no 
brain work and a good deal of muscular exercise, would 
do good, such as walking, running, jumping, and various 
kinds of games; while, on the contrary, exercises of skill 
would be a serious tax. 

The suggestion has been widely accepted, that brain 
work should occupy the morning hours, while technical 
education, such as singing, drawing, and physical training, 
should be given in the afternoon. 

Marks for Physical Efficiency. — The tests suggested 
some fifteen years ago by Sir Francis Galton, the eminent 
English scientist, for assigning marks for physical qualifi- 
cations were the following: First, breathing capacity; 
second, strength tests, both of them to be regarded with 
reference to the stature and the weight; third, quickness 
of response to a signal, made either to the eye or ear; 
fourth, keenness of eye-sight; fifth, keenness of hearing; 
sixth, color sense. 

Dr. Sargent, realizing the usefulness of these tests in 
measuring physical efficiency, included them in the phy- 
sical examinations of the Harvard students. The strength 
tests consist in the strength of each forearm, of the back of 
the legs, the dip, the pull up, and the lung capacity. The 



318 PERSONAL HYGIENE FOR WOMEN 

combination of these seven tests is known as the inter- 
collegiate strength test, and is the best means as yet de- 
vised for measuring the general muscular strength and the 
respiratory power. 

The Advantages Derived from Athletic Sports. — 
Nothing can take the place of athletic sports to develop 
strong vigorous bodies in girls and young women. While 
formal gymnastics have both an educational and correct- 
ive value, and lay the foundation for athletic sports, they 
cannot take the place of outdoor sports to develop organic 
vigor, physical and moral courage, self-reliance, judg- 
ment, self-control, decision, and ethical training, a consid- 
eration for the rights of others, and a relaxation, particu- 
larly from mental work. Athletics are to youth what play 
is to children. Groos tells us that a function of play is to 
furnish an outlet for exuberance and animal spirits in the 
young. 

The Ethical Value of Sports for Women. — First 
come the benefits to the individual and second the bene- 
fits to the community, and it is a self-evident fact that 
that which promotes the highest development of the in- 
dividual raises the standard of the community. 

The benefits accruing to the individual are physical, 
esthetic, and psychologic; and as the result of the de- 
velopment of the individual along these lines will result 
the fourth benefit, the social or the " community good." 

Municipal governments are beginning to recognize the 
fact that the maintenance of public playgrounds not 
merely promote the good of the individual, but lessen the 
death-rate, the poverty rate, the criminal rate, and it has 
been found that the working capacity of the people depend 
in some way upon the recreation afforded them. 

Sports for women are essential, not only to better fit 
the individual for her place in life, but as an offset to the 
deadly monotony of her work. The predominating note 
of sports should be joy, exhilaration, and the social fea- 
tures of games. 

Women's sports, like women's clubs, are and should be 



PHYSICAL TRAINING THE KEY TO HEALTH 319 

run along different lines from men's. The object of women's 
games are for their development and individual good, and 
should, therefore, never be played before indiscriminate 
audiences who pay an admission fee. 

Women have the same necessity as children and men for 
a wholesome physical outlet for the exuberance of animal 
spirits and energy. 

The esthetic value of games has been found to be ex- 
pressed in the improvement of the personal habits and 
appearance, which indicates a higher standard of living. 

And the psychologic value has been found to be a 
development of the mental and the moral qualities, and so 
the individual is the better enabled to direct her efforts 
wisely and so more successfully in life's activities. 

All of this is not a matter of theory, but it is the uni- 
versal testimony of the directors of the various athletic 
associations for women all over the country. 

Among other developments along the physical line are 
endurance, skill, precision, and coordination. To be able 
to do physical things well has an ethical value in the indi- 
vidual's attitude toward life in all its phases. 

The esthetic value lays stress upon the beauty and good 
form of games. It is essential in playing games that 
women should stand well, walk well, run well, throw well, 
and have a neat appearance. The manners and habits 
of the players on the field are also part of the esthetic 
training. 

It has also been noted that for reasons largely beyond 
her control the primitive occupations of women have been 
taken out of her hands, and have forced her, in order to 
secure a maintenance for herself, or those depending on 
her for support, out of the home into the industries and 
occupations of the world, together with a fierce competi- 
tion which this necessitates. In other words, success is 
based upon competition, and competition is the keynote 
of organized games. So that one of the values of games is 
to maintain fair, economic, and cooperative rules of com- 
petition. Other things being equal, the athletic man or 



320 PERSONAL HYGIENE FOR WOMEN 

woman who has played according to the rules of the games 
is likely to be fairer than he who knows nothing of clean 
sport. 

Some of the mental qualities developed are observation, 
attention, concentration, memory, imagination, initiative, 
reason, and will power. These qualities are most highly 
developed in the various ball games, from its simplest 
forms to team work, as baseball and basket-ball. 

The moral qualities developed are self-control, unselfish- 
ness, a sense of honor, self-sacrifice, self-confidence, fair- 
ness, democracy of spirit, modesty, and decision. One 
of the qualities which characterizes a good player is that 
she will do the things which are assigned her. Prompt- 
ness and obedience to order are the first laws in any game. 
Throughout the game self-confidence is taught. Each 
player has her own responsibilities, decisions must be 
quickly and accurately made, while overconfidence brings 
a sure defeat. 

If competition underlies all games, it is equally true that 
unselfishness is the basis of all team work. The ability 
to work together requires at every point unselfish adjust- 
ment. One of the first things learned is to appreciate 
another's ability, and the individual egotism, so marked 
in the beginning of the work, is rapidly toned down. 

Closely allied with unselfishness is the spirit of fair play, 
and closely linked with fairness is loyalty and a sense of 
honor, the lack of which makes girls the contempt of boys 
and women the despair of men. It has been averred that 
the social position of woman and her dependence upon her 
lord and master have lead her to become indirect and 
devious, hence her lack of perfect truthfulness and sense 
of honor, so that when put upon her honor she does not 
realize her responsibility. 

Another great advantage that games possess for women 
is that many of them, from their weak physical condition, 
are abnormally sensitive and introspective; they live too 
much on the subjective side of life. While sports are pri- 
marily objective, they afford no opportunity for analysis 



PHYSICAL TRAINING THE KEY TO HEALTH 321 

of feeling; the thought must be riveted on the thing to be 
done. Every girl's school and woman's club which pro- 
vides opportunities for games and sports erect barriers 
against nervousness, morbidity, and too much introspec- 
tion. These qualities which games develop are not mas- 
culine, but human; qualities needed for human fellowship. 

The Forms of Athletic Games Best Suited to 
Women. — Dr. Sargent's conclusions as to the form of 
athletic games best suited to women, coming from a man 
of his wide observation and great experience, should be 
more generally known, and he says, without hesitation, 
that there is no athletic sport practised in which some 
women cannot enter, not only without fear of injury, but 
with great prospect of success. But the feminine type 
of build, whether found in men or women, is a handicap 
in many athletic contests. But these limitations do not 
apply to girls between ten and fourteen years of age. 
During this period girls, if properly trained, will often sur- 
pass boys of the same age in any kind of athletic per- 
formance. Moreover, if girls were given the same kind of 
physical training as boys receive all through their growing 
and developing period, they would be able to make a much 
more creditable showing as athletes when they became 
adult women. In the early history of mankind the men 
and women lead lives more nearly alike, and were conse- 
quently more alike physically and mentally than they 
have become subsequently in the history of highly civil- 
ized people. 

From a physiologic standpoint, woman needs exercise 
just as much as man does, but, in taking up athletics, 
these must be regulated on a different basis. Women, as 
a class, cannot stand prolonged physical or mental strain 
as well as men do, but give them frequent intervals of rest 
and relaxation, and they will often accomplish as much, 
in the twenty-four hours as men do. 

From her physical configuration and her inability to 
bear prolonged physical and mental strain, there are 
certain athletic sports and games that would be likely 
21 



322 PERSONAL HYGIENE FOR WOMEN 

to prove injurious to most women if played in the form in 
which they are played by men. In this group are foot- 
ball, ice hockey, polo, basket-ball, boxing, fencing, pole 
vaulting, and heavy gymnastics. If these sports and 
games should be so modified as to meet the peculiar char- 
acteristics of women, there are none of them that could 
not be played with reasonable hopes of physical, mental, 
and moral improvement. 

The athletic exercises and games to which women are 
best adapted, and in which they are most likely to excel, 
are all forms of dancing, calisthenics and light gymnastics, 
archery, lawn-tennis, swimming, field hockey, lacrosse, 
sprint running, bicycling, rowing, canoeing, golf, skating, 
fencing, basket-baH, and all gymnastic plays and games. 

In all athletic exercises in which women engage, good 
form, rather than great records, should be striven for. 
Women may be excused for not being as strong and en- 
during as men, but they cannot be excused for not being 
more finished and graceful. Good carriage, perfect poise, 
self-command, and exquisite grace and refinement should 
enter into women's athletic performances, and these 
qualities should be taken into consideration by the judges 
in making their awards. 



CHAPTER X 

SYMMETRIC DEVELOPMENT: GOOD CARRIAGE 
AND GRACE OF MOTION THROUGH GYMNAS- 
TICS AND ATHLETICS 

Gymnasiums, Baths, and Athletic Association: a Fundamental 
Part of a Woman's College and a Model Woman's Club; the Vassar 
College Gymnasium; the Standardized Percentage Table for Phys- 
ical Efficiency; Special Medical Blank for Women; Self-made Good 
Physique through Physical Training; Rules for Taking Exercise; 
Gymnastic Dress; the Configuration of the Foot; Correct Attitude 
in Standing. 

Corrective Exercises: Exercises for Developing the Various 
Regions of the Body; Shoulder-blade Exercises; Respiratory Exer- 
cises; Exercise for Forward Projection of Chest and Retraction of 
Abdomen; Shoulder and Back Exercises; Leg Exercises; Squatting 
Exercises for Muscles of Spine and Abdomen; Alternate Kneeling; 
Abdominal Exercises; Balancing Exercises for Poise and Carriage; 
Balancing Exercises for Extending Depth of Chest; Lateral Trunk 
and Waist Exercises; Exercises for Muscles of Back; Exercises for 
Muscles of Abdomen; Swimming Exercises, for Back, Thighs, and 
Abdomen; Rope Pulling-exercises for Back, Chest, Waist, Legs, 
and Arms; Exercises in Trunk Flexions for Back, Abdomen, and 
Legs; Exercises with Chest Weights for Chest, Shoulders, and Arms; 
Boxing and Fencing; Classic and Esthetic Dancing an Essential 
Feature in Physical Training; Figures of the Dance with Some 
Simple Exercises. 

Outdoor Exercises: Effect of Walking on the Heart and Lungs; 
Running; Mountain Climbing; Swimming; Horseback Riding as an 
Exercise; Rowing. 

Athletic Sports: Croquet; Lawn-tennis; Golf; Hockey; Basket- 
ball. 



Gymnasiums, Baths, and Athletic Associations 
a Fundamental Part of a Woman's College and a 
Model Woman's Club. — It has been repeatedly and con- 
clusively proved, in a large series of cases, that the phy- 
sique, carriage, and health of woman can be wonderfully 
improved by regular and systematic gymnastic exercises, 
combined with outdoor exercise and athletic sports. 

323 



324 PERSONAL HYGIENE FOR WOMEN 

Briefly stated, the facts in the matter are these : the bony 
and the muscular systems and the vital organs are the same 
in both men and women, and hence the general scheme of 
physical training, which has been found to be so highly 
beneficial to men, would, if properly modified, be equally 
beneficial to women, and such a training for women is 
urged by the most competent authorities of the day. 

Two-thirds of the body weight consists of bones and 
muscles, and the development, growth, nutrition, and vigor 
of the muscular and bony system can only be maintained 
by such exercises as will call into play the action of all of 
the muscles of the body, that is, the stature, breadth of 
shoulders, and size of the chest, as well as firm, hard 
muscles, are dependent on regular and systematic exer- 
cises, of every part of the body, and through the beneficial 
effects produced through exercise on the respiration, cir- 
culation, and digestion, etc., the brain, nerves, heart, 
lungs, in short, all the organs and tissues of the body, are 
kept in a healthy condition. 

The life of the masses of women to-day is being spent 
under artificial and the most unhealthy conditions; for 
the most part in overheated, ill-ventilated houses, with 
very little time spent in the open air, and without any 
knowledge or practice in games and outdoor sports. 

The occupation, or lack of occupation, of the majority 
of women scarcely calls into play the muscles of the upper 
part of the body. This lack of use of the muscles about 
the shoulders and upper part of the chest is fatal to the 
development of the chest and lungs. 

Outside of housewives and domestics, the majority of 
professional, business, and working women live under a 
very high nervous tension, with but a very slight range of 
physical activity. What they all need is a sufficient variety 
of exercises to call into play all the muscles and the vari- 
ous regions of the body, together with plenty of fresh air, 
amusements, and recreations. And already some of our 
large, wide-awake, manufacturing establishments, con- 
vinced that the practical application of these truths in 



SYMMETRIC DEVELOPMENT 325 

their own factories would both improve the health of their 
employees and be to the financial interest of the firm, 
are now providing well-equipped gymnasiums, under the 
direction of competent instructors, furnished with baths, 
resting-rooms, restaurants, etc., for their employees, and 
these experiments have demonstrated that the improved 
quantity and quality of the work, the lessened amount of 
sickness among the employees, more than compensate 
the employers for the expenditure of money and the time 
consumed in physical recreation. 

It is only within the past decade that the great benefits 
to be derived from a systematic, gymnastic training, 
combined with athletic sports for girls and women, has 
been generally recognized. To-day all our best colleges 
for girls and young women have well-equipped gym- 
nasiums, with a corps of competent instructors, where a 
scientific and systematic course in physical .training is 
given during the winter months, supplemented during the 
fall and spring months by outdoor athletics and games. 
And, further, this course is obligatory during the fresh- 
man, sophomore, and junior years. 

The result of the gymnastic and athletic work done 
at Vassar College for the past fifteen years shows a very 
great improvement in the physical development, the lung 
capacity, and the general health of the students. The 
average lung capacity for women is given as one hundred 
and fifty cubic inches; at Vassar the average lung capacity 
is one hundred and sixty-five cubic inches. 

The Vassar College Gymnasium. — As Vassar College 
has a model gymnasium, an unusually fine corps of in- 
structors, and gives the greatest attention to all the 
details of the physical training of its students, it may 
very properly serve as a model for schools and women's 
clubs throughout the country. 

The instructors all received their training at the Sar- 
gent Normal School, Cambridge, under the direction of 
Dr. Dudley A. Sargent. Hence, it is naturally run along 
the same lines. 



326 PERSONAL HYGIENE FOR WOMEN 

Gymnasium work is carried on from the middle of 
November until the end of March. The gymnasium is 
furnished with the usual apparatus for light and heavy 
work. The entire student body is divided into four 
classes; each class meets three times a week, and the period 
of work in the gymnasium lasts forty-five minutes. This 
is followed by the shower and needle baths. 

The wands and dumb-bells used are wooden ones, and 
vary in weight from three-fourths of a pound to two and a 
half pounds. Other apparatus that might be used in the 
home gymnasium are the chest-weights and the rowing 
machine with a movable seat. 

Instruction in classic dancing is part of the regular gym- 
nastic work. 

The Vassar gymnasium is also furnished with a fine 
swimming pool. The temperature of the water is kept 
at from 75° to 80° F. For beginners it is necessary to 
have a much higher temperature than for expert swimmers. 
Women will be greatly encouraged to learn to swim from 
the fact of the incredibly short time in which the art is 
taught here. Students learn to swim well in ten lessons 
of fifteen minutes each, and the great popularity of these 
lessons renders it necessary to limit the instruction to ten 
lessons. Later in the season, if there is space in the pool, 
the lessons may be resumed. 

Before entering the gymnasium the girl is first of all 
carefully examined by the resident physician and gym- 
nasium director, and the results of these examinations 
recorded. 

A detailed series of measurements and strength tests 
is made and recorded on the gymnasium register. On 
completing the tests, the following card is filled out and 
given to each girl. It has been found that these cards, 
kept by the girls, increase the interest of each in her 
development, and stimulate her to further exertion to 
improve her physique. 



PLATE VIII 




SYMMETRIC DEVELOPMENT 



327 



VASSAR COLLEGE GYMNASIUM.— RECORD OF PHYSICAL 
MEASUREMENTS 



Miss 



Examinations 





First. 


Second. 


Third. 


Fourth. 


Fifth. 




Height 












Centimeters. 


Weight 












Pounds. 


Lung capacity ., . . . 












Cubic inches. 


Girth, chest 












Centimeters. 


Girth, chest, full . . . 












" 


Girth, chest, ninth rib. 












» 


Girth, chest, ninth rib, 
full 












<< 


Strength, back .... 












Kilos. 


Strength, legs 












» 


Strength, chest .... 












ii 


Strength, right forearm 












<< 


Strength, left forearm. 












» 



The instruments needed for making these tests are the 
spirometer and two dynamometers, one to test the strength 
of the muscles of the back and legs and the other to test 
the muscles of the arms. 

Outdoor sports and athletics are begun in the fall, on 
the opening of the college, and are continued as long as the 
weather permits. The students then take up the regular 
gymnastic work until the spring of the year, when athletics 
are again resumed. Here again three hours a week are 
obligatory. It should be stated here that during the 
menstrual period the girls are not only excused from gym- 
nastics and athletics, but absolutely forbidden to -take 
part in these exercises. 

The list of games include croquet, lawn-tennis, hockey, 
and basket-ball. Rowing has always been a favorite 



328 PERSONAL HYGIENE FOR WOMEN 

out-door sport at Vassar. In 1909 horseback riding was 
again taken up; riding lessons were begun in April, and 
two hundred girls took lessons. With the exception of 
about twenty, they all rode astride. An ordinary man's 
saddle can be used, but a somewhat narrower saddle, with 
a higher front, is more comfortable. 

The Standardized Percentage Table for Physical Effi- 
ciency .^The great importance of heredity on the life his- 
tory of the individual is now so generally recognized that 
its record becomes almost as important as that of the 
woman herself. 

The attention of medical examiners is called to the fact 
that more stress must be laid upon the habits of dress in 
women as a frequently predisposing cause of impaired 
physical weakness and tendency to disease. This is em- 
phatically so in the case of high French heels and insuffi- 
cient clothing. About 75 per cent, of the women of to- 
day wear excessively high heels, and quite that number 
take practically no exercise. 

Because of the great variation in the height of the heel 
of the shoe, from 1 to 3 inches, it is essential that the height 
should be taken in the stocking feet; and since the weight 
of the clothing varies at the different seasons of the year, 
the weight should be taken with a minimum amount of 
clothing on. While the chest measurements should be 
taken with a steel tape with all of the clothing of the chest 
removed ; care being taken that the tape does not slip down 
in the back. 

Difference of pulse in the horizontal and vertical posi- 
tions should not exceed 15 beats; and in strong hearts the 
rate is just the same. 

For the proper completion of this examination it is 
most essential that all of the endurance tests should be 
made. 

Hopping Test. — Heart is counted with the stethoscope 
at apex during four consecutive 15-second periods im- 
mediately after hopping. Note per cent, of increase from 



SYMMETRIC DEVELOPMENT 329 

normal during first 15-second period; second, per cent, of 
recovery from first 15-second period to fourth 15-second 
period. 

The ratings are as follows: I. For good heredity, personal 
history, and good present condition, 10 per cent.; II. 
Normal condition of heart and circulatory system, 10 per 
cent.; III. Normal conditions of lungs and chest develop- 
ment, 10 per cent. ; IV. Good condition of digestive system, 
10 per cent. ; V. Normal condition of kidneys, 10 per cent. ; 

VI. Normal condition of nervous system, 10 per cent.; 

VII. Normal condition of generative organs, 10 per cent.; 
Normal condition of muscular system, 10 per cent.; 
Tests of endurance, normal, 5 per cent.; Normal ocu- 
lar and aural tests, 5 per cent.; Normal working effi- 
ciency, 10 per cent. Making for the normal total of 
physical efficiency 100 per cent. 

No applicant should be passed who falls below 7.5 per 
cent, in any one group of tests, or who falls below 75 per 
cent, on the entire examination. 

This medical blank was made to gauge as accurately as 
possible the physical condition of women, on which their 
working efficiency depends. While we cannot measure the 
strength and adaptability of the heart and blood-vessels 
with the same degree of accuracy as height, weight, and 
cheast measurements, yet with the physical examination 
and the tests of endurance we can make a very fair esti- 
mate. And we are entirely dependent for the history of 
heredity, personal history, and that of the digestive and 
nervous systems upon the woman herself; but the history 
of the present condition at least can be to a great extent 
verified or annulled by the physical examination and by the 
present condition. 

By the quickness and conciseness with which the ques- 
tions are answered ; the woman's posture when she does not 
realize that it is being studied ; her movements as she goes 
from one test to another and the way she conducts herself 
throughout this very rigid physical examination, which 



330 PERSONAL HYGIENE FOR WOMEN 

working under high pressure with the aid of a stenographer 
and office nurse, takes one hour to complete; one can judge 
pretty accurately of her working efficiency. 

The applicants should be graded into four classes: 

Class A. Those having an excellent record in all tests. 

Class B. Those having a good average record and no 
poor record in any test. 

Class C. Those having a fair average record and who 
are free from organic defects. 

Class D. Those having some definite organic disease 
which, in the judgment of the examiner, would make it 
dangerous for the individual to undertake any confining or 
laborious occupation. 

Only those who come under Class -"A" or "B" should be 
recommended for any confining or laborious occupation. 
By suitable methods for the correction of faulty habits of 
hygiene and systematic physical training for one year 
those in Class "C" should be able to gain admittance to 
one of the first two classes. 

To be most beneficial to the candidate, after the physical 
examination is completed, there should follow a brief 
personal talk, making suggestions for the correction of 
faulty personal hygiene; and where medical treatment is 
indicated, instructions to place herself under the care of a 
physician. This has from the first been the policy of the 
board and of the medical examiner. 

And on their part, the candidates are now beginning to 
thoroughly realize that these examinations are decidedly 
to their advantage and regard them as a privilege to which 
they are entitled. And the majority of them go out with 
the determination to get and keep well and strong. 

SPECIAL MEDICAL BLANK FOR WOMEN 

Report of Medical Examiner 

In the case of 
Address, 

Place of birth, 
Age, Occupation, 



SYMMETRIC DEVELOPMENT 331 

I. Heredity: Adverse Family History. 

Tuberculosis? 

Insanity or tendency to nervous exhaustion? 

Cancer? 

Heart disease? 

Kidney disease? 

Personal History. 

Acute diseases since childhood? 

Number of days lost in past year through illness? 

Notable increase or decrease of weight during the past year? 

Present Condition. 

Nutrition, color, and condition of skin? 
General appearance, as indicative of health? 
Dress: Habits of: 1 inch heels? 

H. Heart and Circulatory System. 
Temperature? 

Size of heart? Force of apex-beat? 

Murmurs? 

Blood-pressure: Maximal? Minimal? 

Pulse at rest? Horizontal? Vertical? After strength tests? 
Pulse, Character: Normal? Intermittent? 

Irregular? Unequal? 

Blood examination. — 

Absence of varicose veins and hemorrhoids? 

m. Lungs and Chest Development. 

Respiration: Frequency? Normal? Shallow? Deep? 

Auscultation? Adventitious sounds? 

Girth of chest: Repose? Forced insp'n? Forced exp'n? 

Ninth rib : Repose? Forced insp'n? Forced exp'n? 

Normal, in relation to height? 
Depth of chest: Repose? Forced insp'n? Forced exp'n? 
Lung capacity, measured by spirometer? 
Girth of waist? 

Nose: Normal? Obstructed? 

Throat: Normal? Catarrh? Tonsils: R.? L.? 

IV. Digestive System. 

Teeth: Good? Fair? Poor? 

Tongue: Clean? Coated? Pale? 

Breath? 

Functional derangement of stomach? 
" " intestines? 

" liver? 
Normal size of liver and absence of tenderness? 
Normal size and position of stomach and intestines? 
Regularity of stools with normal color and consistence? 
Constipation? Diarrhea? 

Appendicitis? 



332 PERSONAL HYGIENE FOR WOMEN 

V. The Kidneys. 

Quantity of urine for twenty-four hours? 

Frequency of urination? 

Specific gravity and reaction? 

Indican? 

Albumin? 

Sugar? 

Casts? 

Position of kidneys? 

VI. The Nervous System. 

Tendency to headache? 

Character of " 

Pain or tenderness of spinal cord? 

Number of hours that can now be spent in study daily? 

Tendency to nervous exhaustion? 

Character of sleep: Insomnia? 

Mental poise? 

VII. Generative Organs. 

Position and size of uterus? 

Inflammation of uterus? 

Position and size of ovaries? 

Inflammation of ovaries? 

Menstrual flow: Quantity? Frequency? 

Pain: Before? During flow? Length of time? 

Vaginal discharge? 

VIII. The Muscular System. 

Height? Weight? Normal? 

Stretch of arms? Breadth of shoulders? Breadth of hips? 

Posture: Sitting? Standing? Walking? 

Figure? 

Shoulders: Round? Sloping? Scapula prominent? 

Spine? Lateral curvature? 

Abdomen : Normal? Protuberant? 

Feet: Weak ankle: R.? L.? Weak arch: R.? L.? 

Flat:R.? L.? 

Strength of right forearm? Of left forearm? 

Strength of back? Strength of legs? 

Strength of upper arms (push up)? 
Strength of upper arms (pull up)? 

IX. Tests of Endurance. 

How long a time is spent daily in physical exercise? 

What form? 

What is the average rate of speed in walking? 

Does hill climbing cause shortness of breath? 

What out-door sports are practised? 

Length of time required for test walk of three miles? 

Pulse before? After? 

Heart reaction to exercise: Hopping 100 feet? 



SYMMETRIC DEVELOPMENT 333 

Ocular Tests. 

Distant vision: Right? Left? 

Astigmatism? 

Aural Tests. 

' X. General Impression of Working Efficiency. 
Temperament? 
Personality? 
Self-control? 
Initiative? 
Capability? 

Suggestions for Faulty Personal Hygiene. 

Indications for Medical Treatment. 

Remarks. 

Signature of Medical Examiner, , M. D. 

Address, 
Date, 

Self-made Good Physique Through Physical Train- 
ing. — It has not infrequently happened that, by outdoor 
life and physical training, young men and women of frail 
constitutions have developed into strong, robust, and even 
physically powerful men and women. 

While membership in a well-appointed gymnasium and 
athletic association offers the most favorable conditions 
for the symmetric and fullest development of the body, 
and when possible it is advised always to take at least a 
short course in physical training under the direction of a 
competent instructor, yet every woman has it in her power 
to very greatly improve her physical condition without 
these aids. 

Systematic physical training should be begun in child- 
hood and continued all through life. 

Before twelve years of age physical training should be 
the same for both sexes, and girls and boys should have 
their sports and games together. The beneficial influence 
of this will be manifest for both — girls will grow stronger, 
less timid, and more resourceful, and boys will grow more 
refined and thoughtful. 

But even the case of the adult woman, where not only 



334 PERSONAL HYGIENE FOR WOMEN 

physical training but most of the laws of health have been 
neglected, is far from hopeless. A poorly developed chest, 
round shoulders, a beginning spinal curvature, a poor car- 
riage, bad skin, poor circulation, indigestion, constipation, 
and low vitality, with poor powers of resistance to changes 
in the weather and environment, are not insurmountable 
obstacles. But a woman in this condition cannot manage 
her own case. She must consult and place herself under 
the care of a competent physician. 

Two charts should be made out; the first should be a 
detailed outline of her present condition; to the Vassar 
chart already given should be added the physical defects 
needing correction, as round shoulders, poor chest develop- 
ment, palpitation of the heart on exertion, length of walk 
that can be taken comfortably, also the time required per 
mile. As the strength of the heart and lungs increases, as 
shown not only by the actual tests, but also by the increased 
powers of endurance, this first chart will be a matter of 
great encouragement to the woman and a great incentive 
to further effort. In a parallel column to the defects should 
be written the corrective measure for those defects. 
The second chart should contain the ideal measurements 
and strength tests for a woman of her height and weight. 

Rules for Taking Exercise. — The first things to be 
aimed at are the proper ventilation of the lungs, together 
with their development, and the strengthening of the 
heart. During the exercise the windows must be thrown 
wide open, or the very object of the exercise is defeated. 

Always begin with the simplest exercises and stop at the 
first sign of fatigue. The very first exercise will, therefore, 
be the simple respiratory exercises, taken in bed until one 
acquires some control of the muscles; they are then taken 
standing before a mirror, to insure the exercises being 
taken correctly, and after this they should be taken before 
an open window. The respiratory should be alternated 
with the abdominal exercises, and all of these should be 
taken for twenty minutes at a time, at least twice a day, 
on rising and immediately before retiring. 

Two hours should be spent out-of-doors every day. 



SYMMETRIC DEVELOPMENT 335 

If the woman is weak and unused to taking exercise, she 
should walk until she feels the first signs of fatigue, rest, 
and then continue her walk. If the weather is too cold for 
sitting out-of-doors the woman should preferably take two 
short walks each day, one in the morning and the other in 
the afternoon. For invalids about ten in the morning and 
two in the afternoon are the best hours in winter, because 
of the greater warmth of the sun at those times. To be 
effective, exercise out-of-doors must be taken every day 
without regard to the weather, since the system, when in a 
state of activity, is less susceptible to sudden changes of 
temperature than when at rest. 

Exercise should not be taken after long fasting; hence, 
never before breakfast, nor immediately after a hearty 
meaL An hour after breakfast or a light lunch, or two 
hours after dinner, is the best time for regular exercise. 

A certain amount of daily exercise is essential for the 
preservation of the health. A healthy woman should be 
able to walk five miles a day, at the rate of three miles an 
hour, without feeling any sense of fatigue. 

In order to secure the greatest amount of benefit from 
exercise, the mind should be entirely free from care during 
the exercise, so that the woman should leave her cares at 
home and give up her mind and body to recreation while 
she is out-of-doors. 

Regularity in taking exercise is absolutely essential 
to secure good physical development and to maintain the 
body in a condition of health. A fixed hour should be set 
aside for this purpose every day. 

No definite rules can be given for the exact amount of 
exercise to be taken at one time, but the occurrence of 
fatigue is the signal for rest; after a five minutes' rest, 
exercise may be again resumed, to be stopped again at the 
same signal of fatigue. Perhaps three periods of exercise, 
alternating with rest, may be taken, but, in order to do 
good and not harm, the individual must always stop be- 
fore she is tired. 

A period of free exercises should begin with a twenty 
minutes' practice, including movements for arms, legs, 



336 PERSONAL HYGIENE FOR WOMEN 

back, chest, and abdomen, with especial emphasis on the 
correct poise and carriage of the body and deep breathing, 
and it should terminate with running; or, if in a class, with 
a running game. 

For those of mature age and sedentary habits especial 
care must be taken not to overtax the heart, always be- 
ginning with the simplest movements and stopping at the 
first signs of fatigue. 

In the gymnasium the periods of exercise generally 
cover forty-five minutes, with frequent intervals of rest 
in between. Even here an invariable rule should be never 
to exercise to extreme weariness. 

All exercise should be followed by a shower or needle 
bath, and a vigorous rubbing with or without alcohol. 
Very delicate women who have been unaccustomed to tak- 
ing exercise should rest on the couch or bed for one hour 
before proceeding to dress. It is well to sleep, if possible, 
and in this way they will find the good effects of the exer- 
cise very greatly increased. 

Gymnastic Dress. — The usual and best style of gym- 
nastic dress is a bloomer costume, the bloomers coming 
above the knees, long stockings, and thin, flat-soled shoes 
without any heels. The dress must be loose at the neck 
and waist, or it may be cut low in the neck. The sleeves 
are preferably short elbow sleeves. 

If the exercises are taken at home, the woman may wear 
a combination undersuit, with stockings and broad-soled 
heelless slippers. The lighter the dress, the better, so that 
there shall be no sense of weight or restriction about the 
neck, waist, or shoulders. 

By putting on her bedroom slippers any one can easily 
convince herself of the greater grip the foot has on the floor 
when so clad, and of the greater ease and sureness of the 
foot in walking. 

For outdoor athletics a short skirt, coming just below 
the knees, may be worn over the bloomer costume. Ten- 
nis shoes should always be worn. 

All rooms used for exercise, gymnasiums, and ball- 



SYMMETRIC DEVELOPMENT 



337 



rooms must be thoroughly ventilated before the assem- 
blage of the people. The air must be kept cool, between 
50° and 60° F., and proper arrangements must be made to 
keep the room well ventilated while in use without causing 
direct drafts. 

Well-waxed, hard-wood floors are the best, because 
they can be kept freest from dust. Students should never 
be allowed to enter the gymnasium with their street shoes 
on, as they carry with them much dust that will be thrown 
in motion and inhaled during the performance of the vari- 



Os Calcis. 



Astragalus. 




Metatarsal Bones. 
Phalanges. 



Fig. 26. — Upper surface, bones of foot (Allen). 

ous exereises, and there follows not only the irritation 
caused by the inhalation of the particles of dust, but also 
the danger of inspiring all kinds of germs of disease with 
which the air is laden. 

The Configuration of the Foot. — No study of the 
correct attitude of the body at rest or in motion would be 
complete without some knowledge of the structural ar- 
rangement of the foot. The feet form the base of support 
for the entire body, and at every step are subjected to a 
pressure of from one hundred to two hundred pounds. 

22 



338 PERSONAL HYGIENE FOR WOMEN 

This base is in the form of two arches, a transverse and 
an anteroposterior. The latter is the most important, and 
has been subdivided into two by an imaginary line, drawn 
between the third and fourth metatarsal bones. The inner 
portion of this arch is much more curved than the outer, 
and forms the instep. The arch is supported by two 
piers. The posterior pier is formed by the os calcis, or 
heel bone, and the posterior part of the astragulus. It 
is shorter, has but one joint, is more curved, and is, at the 
same time, more solid than the anterior pier, and receives 
the greater part of the weight of the body. The anterior 
pier includes all the bones in front of the astragulus to 
the junction of the three metatarsal bones with the toes. 
It is much the longer, is less curved, and has many joints, 
giving it greater elasticity, and also enabling it to diminish 
the force of shocks transmitted to the arch. The summit 
of the arch is the ankle. 

It is evident that the superincumbent pressure, by 
flattening the arches, both lengthens and broadens the 
foot. The anteroposterior arch is further lengthened by 
a turning upward of the toes, which form a hinge-joint 
with the instep. 

In extension the foot normally rests upon the heel, 
the tips of the metatarsal bones, and the outer side of the 
sole. In walking, running, or dancing the direction of 
the weight upon the arches is constantly changing, and 
it is only through the action of certain muscles that the 
normal arches are conserved. This healthy condition of 
the plantar arch can only be maintained by the evenly 
balanced action of those muscles which surround and 
strengthen the weak parts of the arch. 

Dr. Busey's description of the foot in walking, and the 
injurious effects of the high-heeled shoe, is as follows: 
"In walking the heel touches the ground first, and sup- 
ports the whole weight of the body for a moment. A little 
later the point of the foot touches, and assists in preserv- 
ing the equilibrium by increasing the base. During the 
second movement of walking the heel is raised (see Fig. 



SYMMETRIC DEVELOPMENT 



339 



27, 2), and the weight of the body is shifted more and 
more to the center of the foot and toes, the latter spread- 
ing and pushing the body forward. This last is the 
movement which displays to the greatest advantage the 
suppleness and elasticity of the articulations of the foot, 
and the adaptation of the a'rch to receive the weight of the 
body, and to transfer it to the distal pier, while the body 
is being moved forward by the same act. It is the exe- 




Fig. 27. — The natural and artificial positions of the foot (Camper). 

cution of this movement which gives to the gait of woman 
that elegance and those graceful undulations which are so 
attractive. 

"The narrow high-heeled shoe, on the other hand, by 
displacing the supporting base, causes both piers of the 
double-spanned arch to strike at the ground simultane- 
ously. In consequence of which the gait, instead of being 
undulating, is stiff and hobbling, and the body advances 
by jerks. 



340 PERSONAL HYGIENE FOR WOMEN 

"When standing on the heel bone {NLM, Fig. 27, 1), 
the joint at K, and the great toe C, touch the support 
upon the line A-B. When the feet are shod according to 
the present fashion, the line A-B is made to assume 
the concave form shown in Fig. 27, 3, by BTu. The 
instep is made more convex and rounded, and the 
foot is actually shortened (see a- b, Fig. 27, 3). The 
constant elevation of the heel places the body of the 
pedestrian in the same position as when standing upon an 
inclined plane. Again, the heel is so shaped and located 
that it forces up the keystone of the arch and weakens the 
whole structure." 

The Correct Attitude in Standing (See Fig. 28).— 
The heels are placed nearly together, the toes pointed 
very slightly outward, the legs are rigid, the trunk and 
head are held erect, and the shoulders somewhat back, 
so that the chest shall expand freely. The arms should 
hang easily at the sides ; the fingers are slightly bent, with 
the thumbs in front. This position of "attention" can 
only be maintained comfortably for a very short length 
of time, since the actively contracting muscles soon 
tire. 

If the standing position has to be maintained for any 
great length of time, one foot should be placed slightly 
in advance of the other, the weight being borne upon the 
straight leg and the active supporting foot, the other 
being relatively passive. This asymmetric position has 
the important advantage that the two extremities may be 
brought alternately into play. 

The most common defect in standing is that the entire 
weight is usually borne upon the same leg, generally the 
right one, while the left, being inactive, is placed out to one 
side; the habitual maintenance of this position leads, as 
we shall see later, to a tilting of the pelvis to one side, 
with a consequent spinal curvature and lowering of one 
shoulder. 

Persons with strong feet, especially primitive unshod 
feet, mountaineers, runners, and young children, walk 



SYMMETRIC DEVELOPMENT 341 

with the inner borders of the feet nearly parallel to each 
other and the direction of motion. The best sculpture, 
both ancient and modern, shows the straight supporting 
foot, which in standing is not necessarily parallel with its 
mate, since the resting foot may assume almost any angle 
of divergence. 

The influence of the stability of a correct base is well 
illustrated by standing on one foot and swinging the other 
leg backward and forward, which is much more difficult if 
the supporting foot be turned to one side. A runner finds 
it very difficult to run with the toes turned out, although 
the heels never touch the ground. 

Corrective Exercises. — Many of the most common 
defects, such as a drooping head, round shoulders, flat 
chest, beginning spinal curvature, etc., result from a 
weak and relaxed condition of the muscles, whose function 
it is to move and support these parts. If the head is con- 
stantly bent forward in studying and writing at the desk, 
the muscles at the back of the neck gradually lose their 
tone, and stretch out like a piece of elastic that is con- 
stantly kept on the strain. 

The exercises selected must be such as will strengthen 
these particular groups of muscles, and, while taking the 
exercises, the entire attention must be concentrated on the 
part being exercised. 

Any lack of symmetry in the chest, spinal curvature, 
or actual weakness of the lungs will necessitate the pre- 
scribing of special and carefully selected exercises. 

As to the exercises themselves, they should be so 
arranged as to bring into play in a methodic manner all 
the muscles. All special and corrective work must be 
supplemented by general work, which will increase the 
organic vigor of the heart, lungs, and chest necessary to 
meet the vital demands of the whole system. Games are, 
of course, most useful for this purpose, but the games 
should not be too violent. 

In most free exercises the limbs are used for weights of 
resistance. In a man weighing one hundred and fifty 



342 



PERSONAL HYGIENE FOR WOMEN 



pounds the arms usually weigh about ten pounds each 

and the legs twenty pounds. 

The Causes of Round Shoulders. 
— The general conditions are those 
that produce muscular or constitu- 
tional weakness, as rapid growth, 
overwork, the impure air of ill- ven- 
tilated rooms, acute illness, near- 
sightedness uncorrected by glasses, 
lack of proper exercise, and the 
wearing of clothing supported by 
suspenders bearing on the points 
of the shoulders, tending to pull 
them downward and forward, or 
even to produce a painful deformity 
of the scapula. 

It is the rule rather than the ex- 
ception to find, with round shoul- 
ders, some inequality in the height. 
The right shoulder is apt to be the 
lower, owing to the carrying of 
burdens on the right arm. Habitual 
standing with the weight on the 
right leg contributes to a good 
many cases. Games in which the 
right arm is almost exclusively used 
is another cause. 

The Causes of Spinal Curvature. 
— The spinal column forms the 
central support of the body, and, 
for grace and suppleness of motion, 
its thirty-four joints should be con- 
stantly exercised, as well as the 
muscles which hold it erect and 
support the head upon it, as well 
as attach the shoulders, hips, and 

legs more or less closely to it. In brief, all the muscles 

of the back need varied and regular exercise to maintain 




Fig. 29.— The spinal 
column (Church and 
Peterson). 



SYMMETRIC DEVELOPMENT 343 

the erect position of the body, and from early child- 
hood especial attention should be given to develop and 
strengthen this region of the body. 

The normal movements of the spinal column are flexion, 
extension, side bending, and torsion. Flexion and ex- 
tension take place, for the most part, in the lumbar and 
cervical regions. 

Gould believes that astigmatism is a prominent factor 
in the causation of spinal curvature; the curvature is 
affected by the tilting of the head to one side in reading 
or writing. 

But a faulty postural habit is probably the most fre- 
quent cause both in standing and at the desk. When the 
weight is supported by the right leg, the left being used 
merely as a prop; there is a marked C-shaped curve pro- 
duced, with a lowering of the right shoulder and promi- 
nence of the right hip. This position is assumed by school 
children for long periods of time, and there is a consequent 
overstretching of the ligaments of the spine and hip. 
These cases are generally accompanied by round shoulders 
and flat chest, protrusion of the abdomen, and rotation of 
the vertebrae. 

A muscle can be developed only by the active con- 
traction and relaxation of its fibers. Continuous tension 
quickly tires and lowers its tone, so that exercises given for 
increasing muscular power should be comparatively quick 
and frequently repeated, while those that aim at the 
stretching of muscles and ligaments should be slow and 
long maintained. 

In all cases where corrective treatment is needed the 
first thing to be attended to is the general condition, 
and the best hygienic conditions must be provided, 
the general health inquired into and attended to. In 
all cases the eyes should be examined by a competent 
oculist. 

All exercises and stretching movements should be given 
daily, with a period of rest after three or four movements, 
and they should be so alternated and combined that no 



344 PERSONAL HYGIENE FOR WOMEN 

two, employing the same muscles in the same way, should 
follow one another, and so cause excessive fatigue. 

The Muscles of the Abdomen. — These muscles are most 
important for breathing and therefore for health, for the 
retention in their normal position of the various abdominal 
viscera, for good digestion and regularity of the evacua- 
tion of the bowels. Sluggish digestion and constipation 
are among the commonest evils in life, and they are gen- 
erally connected with relaxed abdominal walls and flabbi- 
ness of the abdominal muscles. Active pressure of the 
abdominal muscles on the viscera massages the liver and 
presses onward the contents of the intestines. 

The protuberant abdomen may either be due to a faulty 
position in standing or an excess of fat in the great omen- 
tum, a membrane intended to protect the bowels. This 
excess of fat may be in turn due to lack of exercise or an 
excess of sweets and starchy foods, and the reduction of 
this superfluous fat by suitable exercises, properly taken, 
together with the attention to the diet, not starvation, is 
the only common sense and safe way for a woman to reduce 
her size. 

The abdominal muscles are used in bending, in stooping 
forward, in raising up from the recumbent position, some- 
what in climbing, and in many other movements. Trunk 
bending forward and backward; lateral flexions of the 
trunk ; bending of the knees down to a squatting position, 
together with torsions, and all exercises derived from these 
types, bring into play and exercise the abdominal muscles. 

EXERCISES FOR DEVELOPING THE VARIOUS REGIONS 
OF THE BODY 

The following list of free exercises has been selected 
primarily for developing the lungs and chest and correcting 
deformities, such as round shoulders, stooping attitude, 
and beginning spinal curvature, when due only to muscular 
weakness and faulty attitude in standing, sitting, and 
walking. 



SYMMETRIC DEVELOPMENT 345 

While each exercise calls into play many other muscles 
than the ones for whose development the exercise is given, 
the exercise is classed under the group for the region which 
it is especially designed to benefit. 

Shoulder-blade Exercises (Fig. 32). — First Position. 
— Stand erect, with the feet nearly together, and the 
palms of the hands brought together above the head in 
the manner shown in the figure. 

Second Position (Fig. 33) . — Throw hands and forearms 
backward, keeping the arms on a line with the shoulders, 
the elbows bent, and turn the palms forward, as repre- 
sented in the second position of the figure. Return to 
the first position, and repeat ten times. These exercises 
strengthen particularly the muscles between the shoulder- 
blades, whose function it is to hold the shoulders back. 

The first point in taking each exercise is to learn the 
correct attitude before a mirror; after this has been 
mastered, the exercises should be taken with a considerable 
amount of rapidity and force, but not so forcibly that the 
collar-bone projects at its junction with the breast-bone. 
In throwing the hands and forearms back, the force of 
the motion should come at the elbows, not at the hands, 
and the shoulders should be carried as far back as possible. 

Shoulder-blade Exercises, Number 2 (Fig. 34). — 
Stand erect, with the feet nearly together, and with 
the hands clasped behind the neck, as seen in the 
figure. Then force the head and elbows strongly back. 
Relax, letting the elbows come forward. Repeat ten 
times. 

It will be readily seen that these shoulder-blade move- 
ments are exercises for the arms and chest as well. The 
object being to raise and broaden the chest. 

Respiratory Exercises (Figs. 35, 36, 37). — First Posi- 
tion. — Stand with the feet nearly together, the chin down, 
the arms extended downward, with the backs of the hands 
touching, as shown in the figure. 

Second Position. — The chin should be raised with the 
arms, so that in the second position the head is held erect. 



346 PERSONAL HYGIENE FOR WOMEN 

Third Position. — The movements of the hands are car- 
ried upward still further and separated as shown in the 
figure. From this position the hands should be brought 
downward in the large sweep of a circle to the original 
position. y 

When these various movements have been accurately 
acquired, forcible respiratory movements should be added. 
Begin to inhale forcibly as the hands are raised, and hold 
the breath as long as possible while the hands are held 
above the head, and exhale forcibly while the arms are be- 
ing brought down. These exercises bring into play the 
muscles of natural and forced respiration. 

Exercises for Forward Projection of the Chest and 
Retraction of the Abdomen (Figs. 38, 39).— First Posi- 
tion. — Stand erect, with the arms behind the back, the 
hands resting in the small of the back, the fingers inter- 
locked, and the palms facing backward. 

Second Position. — Straighten the arms, turn the palms 
inward and then downward, and lastly out, all the while 
keeping the fingers interlocked. Roll the shoulders and 
arms into supination, and extend the neck, as in the atti- 
tude of the second position of the figure. Retain this 
position for a moment, then reverse slowly back into the 
first position. 

When the fingers cannot be held in this position, start 
by holding a loop of cord in the hands, instead of interlock- 
ing the fingers. 

This exercise is particularly valuable for projecting the 
chest forward, stretching the shortened ligaments, and 
drawing in the abdomen. Care should be taken to have 
the chin pressed backward when the arms are brought 
downward and turned outward. 

Shoulder and Back Exercises (Figs. 40, 41).— First Po- 
sition. — Stand erect, with the feet together, and both arms 
extended on a plane with the shoulders, so that in the first 
position the left arm is extended directly in front of the 
body and the right arm on the same plane directly behind 
the body. The arms must be held rigidly on the same 
plane. 



Fig. 34. — Shoulder-blade exercise. Number 2. 




Fig. 35. — Respiratory exercise. First position. 







Fig. 36. — Respiratory exercise. Second position. 




Fig. 28. — Correct attitude in standing. 




Fig. 30. — Correct attitude in walking. First position. 




Fig. 31. — Correct attitude in walking. Second position. 




Fig. 32. — Shoulder-blade exercise. First position. 




Fig. 33. — Shoulder-blade exercise. Second position. 




Fig. 37. — Respiratory exercise. Third position. 




Fig. 



38. — Exercise for forward projection of chest and retraction 
of abdomen. First position. 




Fu 



39. — Exercise for forward projection of chest and retraction of 
abdomen. Second position. 




Fig. 40. — Shoulder and back exercises. First position. 




Fig. 41. — Shoulder and back exercises. Second position. 




Fig. 42, — Leg exercises. First position. 




Fig. 43. — Leg exercises. Second position. 




Fig. 44. — Squatting exercises for muscles of spine and abdomen. 



SYMMETRIC DEVELOPMENT 347 

Second Position. — By a circular movement, the position 
of the left arm is assumed by the right, and vice versa, 
During the entire movement the feet must be kept firmly 
planted on the floor, pivoting at the hips only, while mak- 
ing the continuous circular movement of the arms. 

These movements consist in a torsion of the body 
around the axis of the spinal column, and to these can be 
added deep inspirations from left to right, with expira- 
tions from right to left. In addition to the effect on the 
circulation, the respiratory movements keep up the nu- 
trition and efficiency of the lungs, which in old age undergo 
a kind of atrophy, and also maintain the elasticity of the 
chest-walls, which are apt to become stiff through disuse, 
and so interfere with the movements of the lungs and 
pleura. 

Leg Exercises (Figs. 42, 43). — First Position. — Stand 
erect, with the hands resting on the hips and the legs 
crossed at the knees, with the right foot in front, as shown 
in the figure. 

Second Position. — Swing the right leg outward and 
around back to about eighteen inches back of the left foot, 
as is shown in the second position. Then swing the right 
leg outward and around, back to the first position. 

Reverse the position of the feet, and perform the same 
movements with the left leg. The weight of the body 
must always be thrown on the advanced leg, and perfect 
poise and balance should be maintained throughout the 
entire movement. 

Leg exercises are useful for purposes of relieving the 
engorged veins of the fatigued leg, because the movements 
of such large masses of muscles as those of the legs and 
thighs demand large supplies of blood, and consequent 
quick action on the part of the heart to supply it, and this 
blood, pouring swiftly back to the lungs for purification, 
requires frequent and deeper inspirations on their part to 
effect the purification; leg exercises cause greater develop- 
ment of the chest than do arm exercises. 

Squatting Exercises for Muscles of the Spine and 



348 PERSONAL HYGIENE FOR WOMEN 

Abdomen (Fig. 44). — Stand erect, with the feet near 
together and the hands resting on the hips, rise upon the 
toes, then sink the body to the floor, bending the knees 
sharply, until the thighs and legs are doubled upon each 
other and the weight of the entire body is supported by 
the toes. The trunk must be maintained perfectly erect 
throughout the movement. Then return to the original 
position. Repeat ten times. 

These exercises strengthen the muscles of the spine and 
abdomen, and aid in reducing superfluous abdominal 
fat. They also strengthen the ankles and increase the 
flexibility of the knee-joints. 

Alternate Kneeling; Abdominal Exercise (Fig. 45). 
— While these exercises also strengthen the muscles of 
the spine and legs, they are primarily abdominal exer- 
cises, and are given for the strengthening of the abdominal 
muscles and improving the circulation in the abdominal 
viscera. 

First Position. — Kneel on the left knee, with the face 
directed forward, the right arm extended perpendicularly 
up at the side of the head, and the left hand resting on the 
hip. The head and entire trunk are then turned slowly 
to the left, the right arm all the while being held rigidly 
up at the side of the head, then returns slowly to the 
original position. 

Second Position. — Kneel on the right knee, with the face 
looking directly forward, and the left hand extended above 
the head, and the right hand resting on the hip. The head 
and entire trunk are then turned slowly toward the right, 
and the position maintained for a moment, then return to 
the original position. Repeat five times for each leg. 

These exercises strengthen the abdominal muscles, 
those at the side of the waist, and groins. 

Balancing Exercises for Poise and Carriage (Fig. 
46). — These exercises, for maintaining the equilibrium of 
the body while it is poised upon the smallest possible base, 
are among the most difficult positions to maintain, requir- 
ing a high degree of coordination of movement. They 




Fig. 45. — Alternate kneeling; abdominal exercise. 




Fig. 46. — Balancing exercise for poise and carriage. 




Fig. 47. 



-Balancing exercise for extending depth of chest, 
position. 



First 




Fig. 48. — Balancing exercise for extending depth of chest. Second 

position. 




Fig. 49. — Lateral trunk and waist exercise. First position. 




Fig. 50. — Lateral trunk and waist exercise. Second position. 



SYMMETRIC DEVELOPMENT 349 

are given to improve the poise and carriage of the 
body. 

The position of the right foot in the figure is incorrect, 
since the object of the movement is to have the body 
balanced throughout on the toes only. Stand erect on 
the tiptoes, with the arms and hands extended at the sides 
and above the head, as shown in the figure; then walk 
in the same position, with the hands carried up perpendicu- 
larly at the sides of the head. 

Further benefits in the carriage of the body may be ob- 
tained by carrying light weights upon the head while per- 
forming these exercises, as a light book. 

These exercises, when properly performed, expand the 
chest and bring into play all the extensors of the back 
and elevators of the shoulders. They also round out the 
muscles of the throat and neck. 

Balancing Exercises for Extending Depth of Chest 
(Figs. 47, 48) . — First Position. — Stand erect, with the heels 
together and the hands resting on the hips. Straighten 
out the right arm, and extend it perpendicularly up at 
the side of the head, and at the same time carry the left 
leg outward and upward as far as possible, according to 
the pose assumed in the figure. Then lower the leg and 
arm, returning to the original position. 

Second Position. — Stand erect, with the heels together 
and the hands resting on the hips, as in the first position. 
Then take the same movements with the left arm and right 
leg as were taken in the first position. The arm and leg 
should be raised and lowered simultaneously. 

AH these exercises increase the vertical diameters of 
the chest, and strengthen the muscles of ordinary and 
forced respiration. 

These movements also relieve the engorged veins of 
fatigued legs. 

Lateral Trunk and Waist Exercises (Figs. 49, 50). — 
First Position. — Stand with the feet nearly together and 
the arms extended above the head ; the arms are relaxed 
at the wrists and elbows, so that a slightly curved line 



350 PERSONAL HYGIENE FOR WOMEN 

is formed, as is shown in the figure. First sway to the 
left, bending at the waist line as far as possible, and re- 
turn to the original position. 

Second Position. — The attitude is the same as in the 
first position; sway to the left in the same manner. 

These exercises strengthen the muscles on the sides of 
the abdomen and the lower part of the back, and are an 
excellent means to reduce the size of the waist in case of 
corpulency. 

Exercises for the Muscles of the Back (Fig. 51). — 
These exercises may be taken lying prone on the floor, 
with the feet caught under any piece of furniture which is 
strong and low enough to act as a cross-bar, as a lounge 
or dressing case. No one but an athlete could take this 
exercise without having the feet held down. 

The feet should be held firmly down, and the hands may 
be at the sides or clasped behind the waist; the body is 
then slowly raised and carried backward to the half -sitting 
posture, then gradually lowered to the original position. 
These movements should be taken slowly and not repeated 
more than five times in the beginning. 

In case of stooping or round shoulders, the hands 
should be clasped at the back of the neck instead of at 
the waist. 

Raise the head and extend the spine, pressing the 
elbows backward. This exercise is a severe one on the 
extensors of the back and the rotators of the shoulders. 

Exercises for the Muscles of the Abdomen (Fig. 
52). — Lie supine on the floor, with the feet firmly fixed 
under a cross bar, or a piece of furniture which will answer 
this purpose, and the hands resting on the hips, as shown 
in the figure; slowly raise the body to the upright posi- 
tion, maintain for a moment, and return to the first 
position. 

This and the preceding exercise are both excellent for 
strengthening the abdominal muscles and reducing arj 
excessive accumulation of fat in case of obesity of this 
region. 




Fig. 51. — Exercises for muscles of back. 




Fig. 52. — Exercises for muscles of abdomen. 




Fig. 53. — Swimming exercises: for back, thighs, and abdomen. 

position. 



First 




Fig. 54. — Swimming exercises: for back, thighs, and abdomen. Second 

position. 




Fig. 55. — Rope-pulling exercises: for back, chest, waist, legs, and 
arms. First position. 




Fig. 56. — Rope-pulling exercises: for back, chest, waist, legs, and 
arms. Second position. 



Fig. 57. — Exercises in lateral trunk flexions: for shoulders, chest, 
hips, and legs. First position. 



SYMMETRIC DEVELOPMENT 351 

Swimming Exercises: for Back, Thighs, and Abdo- 
men (Figs. 53, 54). — First Position. — The movements 
given here are those for the breast-stroke in swimming. 
Stand with the feet about eighteen inches apart, with the 
right foot advanced and the right leg straight; the weight 
is thrown on the left leg, and the arms bent at right angles, 
ready for the beginning of the stroke, as shown in the pose. 

Second Position. — Shoot the arms directly forward, 
incline the whole body forward, straighten the left leg, and 
throw the weight on the right, which should be bent, 
as shown in the second pose. Then sweep the hands and 
arms outward in a horizontal plane, until the arms, trunk, 
and legs are brought into the original position. 

Then take the same exercises, reversing the positions of 
the right and left legs. 

In taking these exercises the arms, body, and legs must 
work simultaneously. Special stress must be placed on 
the alternate flexion and extension of the front and rear 
leg and the inclination of the body forward with each 
stroke. 

While these exercises strengthen the muscles of the arms, 
shoulders, and chest, they are especially intended for the 
extensor muscles of the back and thighs and muscles of 
the abdomen. 

Rope-pulling Exercises: for Back, Chest, Waist, 
Legs, and Arms (Figs. 55, 56). — First Position.— Stand 
with the feet about eighteen inches apart, the arms ex- 
tended out in front of the body and well out from the sides; 
the right foot is advanced, and the weight rests mainly on 
the right leg. 

Second Position. — Clinch the hands tightly, as though 
grasping a rope, and sway to the left side, at the same time 
straightening the right leg; bend the left knee, and pull 
the hands toward the waist, as though pulling the rope in; 
then extend the arms and return to the first position. 

Repeat the exercise with the position of the legs re- 
versed. 

The arms must be extended well out from the sides, 



352 PERSONAL HYGIENE FOR WOMEN 

bending at the waist-line, so as to increase the reach, and 
the swaying back and forth must be done with perfect 
regularity. 

This is a good all-around exercise, as it brings into play 
and strengthens the adductors of the thighs, calves, and 
extensors of the legs, the broad muscles of the back, the 
muscles of the chest, waist, and the flexors and extensors 
of the arms. 

Exercises in Lateral Trunk Flexions : for Shoulders, 
Chest, Hips, and Legs (Figs. 57, 58).— First Position.— 
Stand with the feet eighteen inches apart, with the right 
arm extended upward and the left downward, and the 
weight of the body thrown on the right leg, while the left 
leg is extended directly to the side. 

Second Position. — Change the weight to the left leg, 
and bend the left knee while the right leg is extended. 
At the same time bring the right arm down and carry the 
left up and sway the body at the hips to the right side. 
The feet are kept flat on the floor during the entire exer- 
cise, and it will be noticed that the arm, which is extended 
downward, is on the same side as the extended leg. 

These exercises increase the flexibility of the chest, 
strengthen the muscles at the sides of the waist, and 
cause some massage of the liver. 

Exercises in Trunk Flexions : for Muscles of the 
Back, Abdomen, and Leg (Figs. 59, 60). — First Position. — 
Stand with the feet about six inches apart, the body bent 
well forward at the waist-line, while the legs are rigidly 
extended at the knees. Increase the bend gradually at 
the waist until the tips of the fingers touch the floor be- 
tween the feet, as shown in the pose. 

Second Position. — From the first position carry the arms 
directly forward, upward, and backward until they reach 
the position shown in the second pose, with the knees and 
ankles flexed; bend the trunk as far backward as possible, 
while the arms are extended over the head. Maintain 
for a moment, and return to the original position. 

These movements must all be taken slowly, and in the 




Fig. 58. — Exercises in lateral trunk flexions: for shoulders, chest, 
hips, and legs. Second position. 



1 




Fig. 59. — Exercises in trunk flexions: for back, abdomen, and legs. 
First position. 



1 




Fig. 60. — Exercises in trunk flexions: for back, abdomen, and legs. 
Second position- 




Fig. 61.— Chest weight exercises for arms and shoulders. First 

position. 




Fig. 62. — Chest weight exercises for arms and shoulders. Second 

position. 



MMMH1 ! 






K* 


K,l: 


' <1 5fv 4 1 


4 * m - . 
I 1 i 




1 * juiifet 




1 

1 

• 

Ilk 



Fig. 



63. — Chest weight exercises for shoulders and chest expansion. 
First position. 




Fig. 64. — Chest weight exercises for shoulders and chest expansion. 
Second position. 




Fig. 65. — Chest weight exercises for extending depth of chest. First 

position. 




Fig. 66. — Chest weight exercises for extending depth of chest. 
Second position. 




Fig. 67. — Chest weight exercises for chest expansion. First position. 




Fig. 68. — Chest weight exercises for chest expansion. Second 

position. 



Fig. 69. — Figures of the dance. First position of the hands and feet. 



SYMMETRIC DEVELOPMENT 353 

beginning do not attempt to go far back of the vertical 
line. Nearly all the muscles on the front and back of 
the body are involved in these exercises, but the greatest 
strain comes on the muscles of the back and abdomen and 
the muscles on the back of the thighs. The bending and 
rising bring into powerful action the extensors of the back 
and neck and the retractors of the shoulders. 

After this exercise has been mastered, it can be used to 
still further expand the lungs, by forcible inspiration when 
the chest is in the most favorable position for expansion; 
retain the breath while the trunk is flexed, forcing the air 
into the cells of the lungs under pressure. This last fea- 
ture of the exercise should not be attempted by any one 
with weak lungs. 

Boxing and Fencing. — Boxing and fencing are both 
excellent exercises for the lungs, for both sides of the body, 
for balance, for rapidity, for endurance, variety, prompti- 
tude, and sudden adaptation; for originality, up to a 
certain point, as well as for self-reliance and fearlessness. 
They have the advantage of cheapness, and are best prac- 
tised in the open air. 

Exercises with Chest Weights: for Chest Expan- 
sion, Shoulders, and Arms. — These exercises are excel- 
lent for developing the muscles of the upper part of the 
chest, and for rounding out the chest, shoulders, and arms. 
They are also good flesh-reducing exercises. 

The weights should be fairly light at first, beginning 
with perhaps two and one-half pounds, and gradually in- 
creasing until five pounds are used. The weights should 
only be increased with the increase of the strength of 
the individual. All the movements should be performed 
consecutively from ten to twenty times each; then pro- 
ceed to the next movement. 

In taking any heavy exercise great care must be used 
not to overfatigue the muscles, or more harm than good will 
be done. As soon as the muscles have become too tired 
to perform any exercise vigorously, it should be discon- 
tinued, and a rest of a few minutes taken, when the exer- 



354 PERSONAL HYGIENE FOR WOMEN 

cise may be resumed. When a point is reached at which 
the muscles feel tired at the commencement of the exer- 
cise stop at once for the day. 

Chest Weight Exercises for Arms and Shoulders (Figs. 
61, 62). — First Position. — Face the chest weights, grasp 
the handles firmly, and hold the arms straight out in front 
of the chest. Stand with the heels nearly together, and 
far enough away from the weights to raise them a little 
distance from the floor. 

Second Position. — Draw the two handles to the chest and 
almost under the arm-pits, letting the elbows and shoulders 
go well back; then extend the arms. Repeat ten times. 

Chest Weight Exercises for Shoulders and Chest 
Expansion (Figs. 63, 64).— First Position.— Hold the arms 
straight out in front. 

Second Position. — Then, still keeping them in a horizon- 
tal position, throw them back as far as possible. 

Chest Weight Exercise for Extending Depth of 
Chest (Figs. 65, 66).— First Position.— Stand with the 
back to the chest weights, palms forward, arms straight. 

Second Position. — Let the arms go past the sides, back 
and up as far as possible; then bring them down and for- 
ward and return to first position. 

Chest Weight Exercise for Chest Expansion (Figs. 67, 
68). — First Position. — Stand with the back to the chest 
weights, holding the arms straight out in front. 

Second Position. — Then, keeping them straight and in a 
horizontal position, throw them back as far as possible. 
With the arms still extended on a straight line with the 
shoulders, bring them forward until the hands meet in 
front. This is an excellent exercise to expand and develop 
the chest. 

Classic and Esthetic Dancing: an Essential 
Feature in Physical Training. — From earliest antiquity 
the dance has been of universal practice among all peoples 
of the earth, both savage and civilized, and it has been 
made to express all the emotions of which the mind is 
capable of feeling. Dancing held a prominent position 
among the gymnastic exercises of the Greeks. 



SYMMETRIC DEVELOPMENT 355 

The teachers of physical training have long felt that 
even the combination of gymnastics and athletic sports 
left much to be desired in the carriage and movements of 
the body, so classic and esthetic dancing, which stands 
between the two, more closely allied to gymnastics in its 
movements and to games in its spirit, was introduced as 
an additional gymnastic exercise, to harmonize the move- 
ments of the body, and to produce an ease of manner with 
a grace of beauty and of motion. 

Society Dancing. — A sharp distinction must be made 
between the modern gymnastic dancing and society danc- 
ing. In the latter, the waltz and the two-step always 
require a partner. The dancing is ordinarily confined to 
the ball-room, with its poor ventilation and overheated 
air; add to these the constriction of the waist, so that the 
free action of the heart and lungs is interfered with, and 
under these conditions it may even prove a dangerous 
pastime to the young woman with weak heart or lungs. 
As a physical exercise, the waxed floor of the ball-room 
still further reduces its value. 

Gymnasium or Classic and Esthetic Dancing. — For the 
gymnasium dancing there must be, first of all, the loose 
dress and heelless slippers, and an abundant supply of 
fresh air at a proper temperature, while the foot grips 
the floor as tenaciously as in boxing or fencing ; a smooth 
floor renders an artistic execution impossible. The floor 
should be rough or covered with canvas, when dancing 
becomes as good a developer of the heart and lungs as 
running or swimming. 

Girls in good physical condition can keep up esthetic 
dancing for an hour with very few rests or pauses. The 
work done in one hour is about equivalent to a walk of ten 
miles. 

The first steps in the attainment of grace of motion is 
to avoid short, angular, jerky movements, and to learn 
to do everything, even the most difficult exercises, with 
the least expenditure of power and energy. This implies 
considerable muscular strength and great muscular en- 



356 PERSONAL HYGIENE FOR WOMEN 

durance and control. As soon as the dancer loses her 
balance or poise, holds one arm too straight, and bends the 
other one at too sharp an angle, or puts too much stress 
on this movement and too little on that, or makes too 
much effort, the harmony is lost and gracefulness is not 
attained. ' 

The modern gymnasium dancing conforms more com- 
pletely with the requirements of good exercise than ball- 
room dancing, because the trunk, arms, and legs are brought 
more generally into action. While the exercises of the 
feet and calves are not so intense or so concentrated as in 
ballet dancing, the range and the extent of the movement 
are much greater. Not only are the shoulder, back, and 
chest muscles considerably developed by the free use of the 
arms, but so many of the muscles of the lower part of the 
back, abdomen, and thighs are used that greater respira- 
tory power is acquired to sustain the extended action; 
hence, the chest-walls are expanded by the effort, and the 
abandonment of the corset during dancing gives the utmost 
freedom to all respiratory movements. 

Statistics show that some of the benefits accruing from 
a conscientious study and practice of aesthetic dancing are, 
that it raises and develops the chest, lengthens the waist, 
and also reduces its circumference ; the hips are reduced in 
size, the thighs and calves are enlarged, while the ankles 
are made smaller and the insteps are raised and given a 
higher arch. Properly applied and directed, dancing ex- 
ercises are even a cure for flat-foot. 

The improvement noted in thirteen young ladies during 
twenty-five days by M. B. Gilbert is as follows: The 
average increase in the normal chest measure, from half 
an inch to one and a half inches; with the chest inflated, 
from half an inch to one and three-fourth inches. 

The foundation for this coordinate work, from which 
an unlimited variety of the most valuable developing 
exercises is formed, consists of the long-established five 
positions of the feet and five positions of the arms, to- 
gether with positions of the whole body, known as atti- 




Fig. 70. — Figures of the dance. Second position of hands; second 
position of right foot. 




Fig. 71. — Figures of 



the dance. Third position 
position of right foot. 



of hands: third 




Fig. 72. — Figures of the dance. Third position (" amplified") 
of hands; fourth position of right foot, in front. N. B. — When the 
arms are not in motion, the palms must be turned down. 



mm 



Fig. 73. — Figures of the dance. Fourth position of hands; fourth 
position of right foot, in back. 




Fig. 74. — Figures of the dance. Fifth position of hands; fifth 
position of right foot. 




Fig. 75. — Figures of the dance. Forward balance. 




Fig. 76. — Figures of the dance. Backward balance. 




Fig. 77. — Courtesy. 




Fig. 78.— Highland fling. 



Fig. 79. — Hornpipe step "on heels/' pulling down the small ropes. 




Fig. 80. — Swedish step from u Kulldansen. 




Fig. 81. — Circles with hands, from Spanish dances. 



M* 




Fig. 82. — Combination of dance steps. First position. 




Fig. 83. — Combination of dance steps. Second position. 




Fig. 84. — Combination of dance steps. Third position. 



Fig. 85. — On the toe tips. 



SYMMETRIC DEVELOPMENT 357 

tudes, arabesques, poses, elevations, groupings, etc. From 
these precepts are established, whereby steps, attitudes, 
and motions are systematically arranged, according to the 
method, and in strict harmony with time and cadence of 
music. 

The freedom given by such dancing softens the crude 
awkward positions so universal among young people; the 
general carriage invariably improves as the head goes up 
and the shoulders go back; a more elastic tread and an 
easier propelling of the body in walking is gained. Not 
only is the chest broadened and deepened, and fat removed 
from waists and hips, and weak backs strengthened, but 
students gain in quickness of perception, coordination, and 
judgment, as well as in agility and power to keep their 
feet in correct rhythm. 

Esthetic dancing is particularly recommended in all 
factories, stores, and schools where there are any large 
number of girls and women as a recess exercise, because in 
this way they get a great deal of vigorous exercise in a very 
short time. It brings all the large muscle groups into 
action, causes a rapid circulation of the blood, aerates the 
lungs, and it affords the best possible sort of a contrast 
to their monotonous and cramped positions; it is most 
exhilarating and it is good fun. It is an excellent mental 
tonic and physical invigorator; it brightens the day, and 
enables the women to do better work. 

FIGURES OF THE DANCE WITH SOME SIMPLE 
EXERCISES 

Fundamental Positions of the Hands and Feet (Fig. 
69). — First Position of the Hands and Feet. — Stand erect, 
resting on the balls of the feet, with the chin up and the 
chest high; arms straight down almost touching the body; 
hands about 6 inches apart, slightly curved, palm toward 
palm; the thumb opposite the middle finger, elbows held 
slightly away from the body as in the figure. Stand with 
the heels together and the feet turned out so as to form a 
right angle. 



358 PERSONAL HYGIENE FOR WOMEN 

Second Position of the Hands and Feet (Fig. 70) . — Move 
the hands and arms away from each other until the hands 
are about 3 feet apart as in the figure. Move the right 
foot directly to right in line with left foot and about 12 
inches away from it; toe touching floor, instep well arched, 
heel raised and kept turned toward left heel as in Fig. 70. 
Counterpart for left. 

Third Position (Fig. 71). — Bring the elbows up until 
they and the hands are in line with the shoulders, finger- 
tips almost touching across chest, palms toward the body 
as in the figure. Move the right foot forward until the 
right heel is in the hollow of the left foot and at right angle 
to it as shown in the figure. Then move the right foot 
back of the left until the hollow of the right foot is back of 
the left heel. Notice that the feet should touch closely and 
the legs be very straight. Counterpart for left foot. 

Third Position of Hands Amplified (Fig. 72). — Extend 
the hands to the sides in a straight line with the shoulders; 
if this position is to be maintained turn the palms toward 
the floor, with the thumb under the middle finger. 

Fourth Position of the Right Foot in Front (Fig. 72).— 
Move the right foot directly forward about 12 inches in 
front of the left foot, as in the figure, toe touching the 
floor, heel raised; instep arched. Counterpart for left 
foot. 

Fourth Position of Hands (Fig. 73).— Move hands and 
arms up until the hands are about 3 feet apart above the 
head; palms toward each other, arms nearly straight as in 
the figure. 

Fourth Position of Right Foot in Back (Fig. 73).— Move 
right foot about 12 inches back until in line with left foot, 
toe touching floor, heel raised as in the figure. Counter- 
part for left foot. 

Fifth Position of Hands and Feet (Fig. 74).— Move hands 
more closely together until about 6 inches apart; palms 
toward each other and the arms very slightly bent as in 
the figure. 

The right toe touches the left heel in back, or right heel 



SYMMETRIC DEVELOPMENT 359 

touches left toe in front as in the figure. The feet are at 
right angles. Counterpart for left foot. 

Elevated Position of the Feet. — The second and fourth 
positions may be elevated by extending the leg and foot at 
right angles to the body. See Figs. 70, 72, 78, 82, 83, and 
84. The third and fifth positions become elevated by rais- 
ing the foot, toe pointed to the floor, as in combination of 
steps, Figs. 78 and 82. 

N. B. — In elevated positions the toe must be extended 
so that the foot and leg form a straight line. 

Simple Exercises Using the Fundamental Positions. — 
Stand with feet in first position; hands in first position 
(Fig. 69) . — Exercise 1 . — Move right foot to second position 
(Fig. 70), and back to first position four times. Left foot 
the same. 

Exercise 2. — Move right foot from fourth position in 
front (Fig. 72) to fifth position in front (Fig. 74). Repeat 
four times. Right foot in back (Fig. 73), fourth to fifth, 
four times. Left foot in back, fourth to fifth, four times. 

Exercise 3. — Move right foot from second position to 
third in front, to second, to third in back. Repeat four 
times. Left foot the same. 

To make the exercise more difficult, hold the skirt ex- 
tended with the hands in the second position (see Fig. 77). 
Or arms extended in third position amplified, palms down, 
which is very difficult. 

Music in 6/8 time will add interest. 

Arm Movements. — Exercise 4- — Move hands from first 
position to second and back to first. Repeat four times. 
N. B. — Draw the hands away from each other by the 
wrists, and toward each other by the wrists. The hands 
should move as though trailed through water. 

Exercise 5. — Move the hands from the third position, to 
the third position amplified, and back again to third (Figs. 
71, 72). Repeat four times. N. B. — Move to third posi- 
tion from first position. Do not go directly from the first 
position to third position amplified, but through third 
position in front. 



360 PERSONAL HYGIENE FOR WOMEN 

Exercise 6. — Move hands from fourth to fifth position, 
four times. 

Exercise 7. — Move right hand to fourth position, left 
hand to second position, starting from third in front, back 
to third position. Repeat four times. Change hands, 
moving right to second, left to fourth position. 

Use slow rhythmic waltz music for exercises 4 to 7. 

Combination of Hand and Foot Movements. — Waltz 
music at first and later 6/8 time. 

Forward Balance (Fig. 75). — Step forward on right foot, 
left foot extended in fourth position back; right hand in 
fourth position, left hand in second. 

Backward Balance (Fig. 76). — Step back on the left foot, 
raising the right foot in elevated third position in front; 
right hand in third position in front of waist, left hand in 
fifth position. Counterpart, starting with left foot. 

Courtesy (Fig. 77). — Grasp the skirt lightly at either side 
between the fingers, keeping the backs of the hands for- 
ward; hands in second position. Point the right toe in 
second position. Count, "One, Two." Lifting the heels, 
turn on both toes until you face toward the left. Count, 
"Three, Four." 

Place the left foot in fourth position back of right foot, 
bending both knees as if you were sitting down. Count, 
"Five, Six." Slightly spread the skirt. N. B— Keep the 
body erect from the waist up. 

Rise to the standing position, drawing the right foot 
backward into the first position. Count, "Seven, Eight." 

Counterpart for Courtesy to the left. Music, Gavotte 
or Schottische played slowly. 

Highland Fling Step (Fig. 78). — Point right foot to sec- 
ond position, right arm is bent at elbow and wrist, left arm 
is almost in fifth position. Hop on left foot, at the same 
time bringing right foot in very elevated fifth position 
back of left knee. Hop on left foot bringing right foot in 
front of knee; hop on left foot bringing right foot back of 
knee again. Repeat to the left with hands in correspond- 
ing positions. 



SYMMETRIC DEVELOPMENT 361 

Hornpipe Step (Fig. 79). — Keeping feet in first position, 
walk forward on the heels very quickly, taking steps of 
about 1 inch in length. Look up and with the hands keep 
pulling down an imaginary rope, moving one hand con- 
stantly above the other. 

Swedish Step from " Kulldansen" (Fig. 80). — Place right 
heel in second position, arms in second position modified. 
Bow to the right, bending at the waist. Repeat to the 
left with the left heel in the second position, right foot in 
first position. Repeat several times. 

Spanish Circle with Hands (Fig. 81). — Kneel on the left 
knee. With both hands make circles going from left to 
right, sweeping from third position at floor level to fifth 
position and back again, four times. 

Combination of Dance Steps — First Position (Fig. 82). — 
Left foot in fifth position front. Swing the left foot in 
circle to fifth position in back. Right hand holding skirt 
in third position in front, left hand holding skirt in third 
position amplified. 

Second Position (Fig. 83). — As left foot arrives in back of 
right, swing arms to third position amplified. Move the 
left foot to second position. 

Third Position (Fig. 84).— Move the left foot to the fifth 
position in front, kicking the right foot in second position 
elevated. Right hand in third position; left hand in third 
position amplified. 

Pose on Toe Tips (Fig. 85). — Rise on the tips of the toes, 
the feet as close together as possible, bringing the hands 
from the first to the fifth position. 

When the pupil has mastered these very skilfully ar- 
ranged series of dancing poses, steps, and exercises she 
has learned how to dance; that is, she is in a position, after 
watching any new dance for a short time, to go on the 
floor with a leader. 

Women in the prime of life will be interested to know that 

in twenty lessons of one-half hour each, given at the 

Women's University Club under the able instruction of 

Miss Rabinovitz, 1 to a class of women ranging in age from 

1 Superintendent of Dancing, New York Public Schools. 



362 PERSONAL HYGIENE FOR WOMEN 

thirty to fifty years, two-thirds of whom had either never 
learned to dance or who had not danced since childhood, 
not only learned the above various dancing steps and 
exercisers, but also the following dances. 

The Folk Dances were : The Tantouli (Swedish) ; Ace of 
Diamonds (Danish); Reap the Flax (Swedish); and the 
Sailor's Hornpipe (English). This last dance was es- 
pecially for the very excellent exercise which it afforded. 
The Minuet was taught for form, grace of movement, and 
exercise. There were also taught the Hesitation Waltz, 
the Maxixe, and the Lulu Fado. 

Outdoor Exercise. — Outdoor exercise must be regarded 
as one of the essentials to good health, and as such must 
be classed with food, clothing, bathing, and sleep. 

In addition to the beneficial effects of exercise on the 
muscles, circulation, and all the functions of the body, are 
the soothing effects of outdoor life on the nerves. It is 
only out-of-doors, in the parks, in the country, or by the 
sea that one is soothed into entire oblivion and forgetful- 
ness of the cares of life, and to such a degree that the in- 
dividual may be said to be hypnotized by the powers of 
nature, so that the mind is almost as perfectly at rest as in 
a sound sleep. 

The time spent out-of-doors should not be less than 
two hours daily. Actual experience of busy workers will 
prove that not only is this time not lost, but that actually 
more and better work can be done in the day, and that the 
resulting improvement in the general health will be so 
great that much less time will be lost through indisposition 
and actual sickness, so that the daily outdoor exercise 
will be found to be a great economic gain. 

Outdoor exercises, such as walking, running, swimming, 
and hill and mountain climbing, possess the very great 
advantage that indulging in them demands no expense, 
and are, therefore, open to all. All these exercises de- 
velop the lungs and chest and strengthen the heart, and 
are, therefore, classed under exercises of endurance. 

The Effect of Walking on the Heart and Lungs. — 



SYMMETRIC DEVELOPMENT 363 

In a slow walk the respiratory action is almost double the 
ordinary amount; in walking at an ordinary pace, that is, 
about three miles an hour, it is four times as great; while 
in a vigorous or hasty walk, that is, at a rate of from four 
to six miles an hour, it is from seven to nine times as 
great. 

The change of speed from three to five miles an hour 
elevates an automatic, listless occupation into a vigorous 
exercise, employing many new muscle groups and stimu- 
lating the heart, lungs, and skin, while the change from a 
smooth, level road to the broken ground of the mountain- 
side may be dangerous for many a one who is able to walk 
at a moderate speed on level ground. 

In walking the clothing must be sufficiently loose not to 
interfere with the more rapid respirations and the increased 
action of the heart. When the heart cannot keep pace 
with the demanded speed of the circulation, a " stitch " 
ensues, and getting one's second wind means that the heart 
has succeeded in accommodating itself to the strain. Too 
great a "stitch," resulting in absolute breathlessness, 
is a warning that must not be disregarded. 

This increase in the respiratory action is important, 
as compared with the brief and transient increase from 
exercise with apparatus, because a quick walk can easily 
be kept up for several hours. 

The fatigue is small, because, in the first place, of the 
abundant supply of oxygen; the will is scarcely used, and 
walking is almost automatic, partly because the muscle 
areas used are large, and each movement prepares for the 
next. Walking is a heart and lung exercise of a very ex- 
cellent sort. 

The Effect of Walking on the Movements of the Blood in 
the Legs. — The circulation of the blood depends on the 
pumping of the heart, which is in turn affected by the suc- 
tion action of the lungs and the muscular movements of 
contraction and relaxation which go on rhythmically. 
While in prolonged standing the veins of the legs become 
fuller, and the circulation of blood in them more sluggish, 



364 PERSONAL HYGIENE FOR WOMEN 

and by the laws of gravitation the blood is kept down in 
them. Hence also in walking slowly with short steps the 
legs remain overfull of blood and become heavy. Instead 
of being quickened, the circulation is actually hindered, 
for the waste-products are not carried away quickly enough. 
Hence, slow walking soon causes a feeling of fatigue, while 
the vigorous walker, going along with long strides, keeps 
fresh. 

Rules for Long Walks. — In walking, not only the dis- 
tance should be taken into account, but the character of 
the road and the incline of the ascent. A distance that 
could be easily covered on a smooth, level highway may 
mean double the expenditure of muscle and nerve force if 
the ground is sandy or very damp. Other hindrances to 
be taken into consideration are opposing winds, not only 
because of the resistance, but also because of the inhala- 
tion of dust and rain. 

The walk should be occasionally broken for short periods 
of rest. The pauses should be short, about five minutes, 
and during this time the body should be erect. Experi- 
ence proves that sitting down makes one more tired on 
getting up again. A short halt should be made before 
climbing a steep ascent, so as to begin with fresh strength 
and easy breathing, as this means increased work for the 
heart and lungs. 

In starting out for a walk, one should begin slowly, and 
gradually increase the pace, and in returning the same rule 
should be observed. 

Running. — The force exerted in running is enormous. 
In running it is the length of the step more than anything 
else which increases the speed of the run; hence, the runner 
should learn to take long steps. But the greatest speed 
can only be kept up for a limited time; the distance is one 
hundred yards. 

Running is the most effective of all exercises of speed, 
and, like all exercises of speed, can be changed into one of 
endurance by a certain moderation in the pace. By 



SYMMETRIC DEVELOPMENT 365 

running the heart and lungs are developed more than by 
any other exercise. 

Age Limit for Running. — All ages are not equally well 
adapted for running: they do not all share in its good 
results. Running is best for all young people, before and 
at the age of puberty. Running is then quite a necessity. 
The growing child is always ready for a run. From the 
fortieth year on running, as an exercise of speed, becomes 
less and less desirable, and, when the organs of circula- 
tion or breathing are impaired, it must be absolutely 
forbidden. 

In running always begin slowly — running moderately, 
for instance, for fifty feet ; then increase the speed gradually, 
but when running for exercise, never speed to the utmost, as 
this is not necessary for the benefits of the exercise. 
Always close the run with the same moderation with which 
it was commenced ; that is, never stop short, as this sudden 
arrest of action gives a most undesirable shock to the heart. 
The movements of running may easily be imitated in the 
house, while standing in one place, and simply lifting the 
feet in the same quick alternation from the floor. 

Mountain Climbing. — The advantages of mountain 
climbing are manifold. The weight of the body has to be 
carried up a certain height. To accomplish this the work 
of the muscles is increased; the breathing must be deeper 
to satisfy the increased demands for oxygen; fresh air is 
admitted into the apices of the lungs, which do not, as a 
rule, participate in respiration. A more powerful action 
of the heart takes place, but care must be taken that this 
is not carried too far. Slow climbing, without any un- 
necessary waste of energy and with appropriate pauses, 
to allow the heart to recover, is advantageous. One 
should not talk too much while climbing. The dress 
should be suitable ; the neck must be free and the shoulders 
not heavily weighted, so that they may be drawn back 
and the chest fully expanded. 

Swimming. — Of all outdoor exercises for women, 
swimming is one of the most perfect. It not only calls 



366 PERSONAL HYGIENE FOR WOMEN 

into vigorous action most of the muscles of the body, but 
spares many of those muscles which are so commonly 
overworked, most of the work being performed by muscles 
which are so little used as to have become weak and 
flabby. 

For instance, the extensors of the fingers and the hand, 
that are so constantly stretched in sewing and writing, 
are in constant use in swimming, while the corresponding 
flexors, the slaves of the needle and the pen, are relaxed. 
Again, the muscles passing from the shoulder-blades to 
the trunk, on which depends much of the erect carriage 
and strength of the chest, which have become wasted from 
disuse while the woman sat at the desk or bent over her 
sewing, are the very muscles by which the movements 
of the upper half of the body are executed, while all the 
muscles of the lower extremity are brought into use. 
Of especial value is the free movement of the hip-joint, a 
joint that is seldom moved with any degree of freedom 
from the time a girl leaves climbing trees, unless she has 
the advantage of special gymnastic training. The vigor- 
ous action demanded of the respiratory muscles greatly 
increases the chest capacity. 

The body is lighter than the water, and is perfectly 
supported by it, so the weight is taken off the spine, and 
the muscles of the back are relieved from their normal 
state of tension. The head is the only part of the body 
that is held up by muscular action, and, in floating, even 
this is supported by the water. 

The disadvantages arise from the fact that the tempera- 
ture of the water is very much below that of the body, 
so that there is a greatly increased conduction of heat from 
the body, and, unless this loss is made good by exercise, 
there is very great danger of a chill. In most persons a 
prolonged stay in cool or cold water produces a liability 
to cramp. 

During the month of August the temperature of the 
ocean reaches its maximum of 66.65° F. This is about 
32 degrees below the temperature of the body. Upon 



SYMMETRIC DEVELOPMENT 367 

entering the water the first effect noticed is a sensation of 
cold; this varies with the susceptibility of the individual, 
and the difference between the temperature of the water 
and the surrounding air. The skin assumes the appear- 
ance of " goose-flesh/' the face is pale and anxious, and 
the lips are blue; the pulse decreases in frequency, a sense 
of oppression is manifest,, and there may be spasmodic 
shivering; that is, the first effect of immersion is to cause 
a contraction of the blood-vessels of the surface of the 
body. This should be quickly followed by a secondary 
reaction, in which there is a sensation of warmth, a quick- 
ened pulse, and an increase of energy. When, by taking 
the proper precautions, this reaction does not occur, it is a 
contraindication to sea-bathing and swimming. 

If the immersion has been too prolonged, there is a 
second sensation of chilliness, a signal that the bather 
must leave the water at once. 

The best time for bathing is between eleven o'clock in 
the morning and four in the afternoon, depending on the 
tide. No one should go into the water within two hours 
after meals, nor should she on leaving the bath proceed 
at once to the table, since digestion draws the blood from 
the periphery to the stomach, and to eat immediately 
after bathing is to lose most of the benefit of the saline 
treatment. 

All should avoid cold-water bathing when fatigued, 
and swimmers ought to pay especial attention to this point, 
on account of the demand they are going to make on their 
muscular system; and on no account must one enter the 
water when in a perspiration; a moderate walk along the 
shore should be taken until the perspiration has subsided. 
These precautions are of the highest importance, and dis- 
regard of them may prove fatal. 

Enter the water quickly until it reaches the waist, then 
plunge headlong, or cover the body to the neck. Care 
should be taken to wet the chest and abdomen immedi- 
ately on entering the water, since these parts are the most 
sensitive to the impression of cold. 



368 PERSONAL HYGIENE FOR WOMEN 

Every one should learn to swim, and those who cannot 
must move the arms and legs about vigorously. The 
duration of the bath should depend on the state of the 
health of the individual, on the state of the weather, and 
on whether the water is rough or calm. The average dura- 
tion of the time spent in the water should be from three to 
fifteen minutes, the latter being the maximum time for 
any one. No benefit will accrue from spending a longer 
time than this in the water, and much harm may result. 

The sea-bath should be followed by moderate exercise, 
in order to insure a perfect reaction, and to aid in expend- 
ing the superfluous energy which sea-water imparts. 

Swimming and sea-bathing should be avoided by per- 
sons who have weak hearts and a poor circulation, in 
whom the reaction after a plunge into cold water is never 
well established. Also by persons with heart or kidney 
disease, and by all feeble and old persons. 

Persons with feeble constitutions, but with no actual 
disease, as in various forms of nervous disorders, insomnia, 
etc., generally derive marked benefit from sea-bathing. 

Persons who are weak should walk and not plunge into 
the water. As in all other exercises, a determination on the 
part of the weak to equal the strong is a fertile cause of 
mischief. 

Horseback Riding as an Exercise. — The advantages 
claimed for horseback riding are that it acts on nearly 
every muscle of the body, while the mind is interested and 
refreshed. An insuperable disadvantage to the majority 
of women living in large towns and cities is the enormous 
cost of the exercise. 

The value of horseback riding for women has been greatly 
diminished by the very faulty position caused by the side- 
saddle, which produced a cramped position of the body and 
a tendency to lateral curvature of the spine. Then, too, 
women ride too tightly corsetted, thereby preventing much 
good that would otherwise accrue to the circulation and 
digestive organs. 

When the woman rides astride, the body is held erect 



SYMMETRIC DEVELOPMENT 369 

and in a natural position, and she sits much more 
firmly on her horse and, if not corsetted, it becomes an 
exhilarating and delightful form of exercise. The best 
results will probably be found in a neurasthenic class of 
women, who are not strong enough to take more active 
exercise, and for them it will be of decided therapeutic 
value to both mind and body. 

Rowing. — This is one of the most beneficial of exercises; 
it has the advantages of scenery, freedom from dust, and 
companionship ; it exercises equally both sides of the body 
and most of the muscles. It is an excellent exercise for 
strength, rapidity, and endurance. 

In correct and graceful rowing there is a pendulum-like 
movement from the hips. The rower should sit with 
the trunk fully extended, the head up, the eyes to the front, 
the chest thrown forward, and the weight of the trunk 
equally distributed upon the two sides of her seat. The 
feet rest against the stretcher, the two hands should be 
near together, and should be held symmetrically at an 
equal distance from the body. 

Stretching. — The body and extended arms are brought 
forward as far as possible. The spinal column should be 
kept extended, not bent so as to make a crooked back, 
and the trunk should be thrown forward from the hip- 
joints. When the stretch has reached its forward limit, 
the oar is dipped into the water just far enough to cover it; 
then immediately the pull begins, and it must be continued 
evenly to the end. 

The Pull. — The body rises erect from the hips and 
swings backward. The hands should not reach the front 
of the chest until the body has passed the perpendicular 
and is sinking back. When the pull is finished, the hands 
are dropped and suddenly bent toward the wrists. This 
lifts the oar out of the water, and keeps its lower surface 
parallel with it; during the stretching forward, the oar 
is kept parallel with the water, so that it has not much 
resistance from the air. 

The muscles brought chiefly into play are the long 

24 



370 PERSONAL HYGIENE FOR WOMEN 

muscles of the back in the backward swing, and the ab- 
dominal muscles in the forward swing. But the muscles 
of the pelvis, thighs, and legs all have to work, likewise the 
muscles of the arms, chest, and shoulders. And it is one 
of the best exercises for developing the lungs and chest, as 
well as of strengthening the heart. Fatigue will be felt 
most in the muscles of the legs, hips, and arms, but the 
exertion is so well distributed that it causes much less 
fatigue than would otherwise be the case. 

Athletic Sports. — Athletic sports possess three distinct 
advantages — they are played out-of-doors, and give an 
incentive to taking the proper amount of exercise; they are 
all team games, and so develop the social and cooperative 
spirit; and last, but by no means least, they afford a great 
deal of amusement and real recreation. 

Formal and systematic gymnastics are essential for the 
development of the body and the correction of its defects; 
out-of-door exercise is excellent, but the solitary walk, 
climb, swim, or row leaves much to be desired, while in 
walking especially the mind is free to pursue the same 
trains of thought which with it was occupied at the desk, 
and so it fails to be properly refreshing to the mind and 
body. Whereas in all athletic sports the ego has to be 
pushed into the background, with all its interests, the 
day's work left behind, and the entire attention concen- 
trated on the play. This is a very distinct advantage to 
the individual. 

Women at all ages take themselves and life too seriously. 
This is in all probability due to a defective early education; 
between the long school hours, home study, housework, 
and sewing, they had neither time nor opportunity to cul- 
tivate a love for play and games, and so the play instinct 
was not developed, and if not developed in youth, the 
chances are that it never will be. In middle and advanced 
age, when the stress and storm are at their height, nothing 
is so sure a restorative to overtaxed brains and over- 
wrought nerves as games, sports, and a love of fun. 

As a result of our unnatural mode of life in youth, it has 



SYMMETRIC DEVELOPMENT 371 

come to pass that American women especially have been 
defrauded out of their birthright of the love of games and 
sports. Athletic games and sports are as essential to a 
scheme of education as are reading, writing, and arith- 
metic. 

Other distinct advantages accruing to athletic games 
are that here the individual becomes acquainted with her 
powers and weaknesses. In formal gymnastics the move- 
ments follow each other in a regular sequence, through 
lines already carefully laid out ; in games, on the contrary, 
no two plays or combination of plays are exactly alike. 
One can never tell what her opponent is going to do, and 
yet what one's opponent does is so vital to the success or 
failure of the game that the player must decide quickly 
and accurately how that move in the game can best be 
met, so that intense concentration, quickness, alertness, 
prolonged attention, self-control, and even self-sacrifice 
are called for, for in the team game the individual inter- 
ests must be submerged, in order that the side may win; 
and so the individual power, sense of responsibility, and 
an esprit de corps are developed, in a manner almost im- 
possible in the same degree in any other way. 

The principal outdoor games for women are croquet, 
lawn-tennis, hockey, golf, hand-ball, basket-ball, baseball, 
boxing, and fencing. 

Croquet. — Of all these games, croquet is the mildest, 
and for that reason is a good beginning game for a woman 
who has always led a sedentary life, or for a woman who 
has become enfeebled through serious illness. It is also 
an excellent game for old age. 

To be beneficial and not detrimental, the exercise must 
be very gradually increased, both in the length of time oc- 
cupied and in the vigor of the movements. The muscles 
must be slowly built up and improved in tone, the lungs 
developed, and the heart strengthened. 

Another advantage of croquet is that it is inexpensive 
and requires a limited amount of ground. 

Lawn- tennis. — Tennis is a much more violent exercise 



372 PERSONAL HYGIENE FOR WOMEN 

than croquet, and is a game for young people and youth. 
Now, as to just what constitutes youth: it is altogether a 
question of the condition of the arteries, heart, and mus- 
cular system, and is not a question of years per se. 

The game is moderately expensive; played with four, 
it is not at all violent. It is an excellent game for social 
purposes, and can be kept up until late in life, but it cannot 
be begun late in life. It has just the proper amount of 
variety, activity, and endurance to suit hundreds of 
people for whom croquet would be too mild, and for whom 
ball-games would be too severe. 

Golf. — Golf is deservedly a very popular game at all 
ages. Perhaps the greatest drawback for the city dweller 
is the inaccessibility of the golf links and the great expense 
of the game. 

It combines scenery, walking for several miles, some hill 
climbing, and a considerable amount of exercise for the 
right side of the body, particularly for the right arm, and 
the muscles of the right side of the back and chest. The 
great drawback, from the physical standpoint, is an over- 
development of the muscles of the right side of the body, 
which, in the majority of people, are already better devel- 
oped than those of the left side ; the muscles of the left side 
of the body are brought very slightly into play. 

While the distinct advantages of the game are combined 
with walking, the healthy body swings, the accuracy 
needed in making the drives, the distance of the drives, the 
variety of implements as well as of stroke, and many other 
features, and, further, it is a game that keeps one pleasantly 
employed in a company of one's choosing for several 
hours. 

Hockey. — Hockey is among the finest of games for 
most young people, and should rank at least third among 
games. It has most of the advantages of foot-ball, and 
many of the advantages of cricket. It involves a consider- 
able amount of running and a great deal of real sport and 
fun. 



SYMMETRIC DEVELOPMENT 373 

Basket-ball. — This is another of the most popular 
games for young people, and possesses in a very great 
degree all the advantages of a team game. The confi- 
dence that follows a successful throw proves of considerable 
value, unless it leads to the carelessness of overconfidence. 
Faith in the ability to get out of a desperate situation in 
the tossing increases with success. This leaves the atten- 
tion imperturbed, and one does not go to pieces. Ac- 
cording to Mosso, movements develop the brain, and it has 
been repeatedly noticed that intelligence in animals in- 
creases with the increased motility of their extremities. 



INDEX 



Abdomen, protuberant, 344 
causes of, 344 

treatment, 45, 52, 298, 344 
Abdominal exercises, 344, 346, 
348 
muscles, 344 

development of, 344, 346, 

348 
flabby, 147 
function of, 146, 344 
Ablutions, 33, 34 
cold, 34 
hot, 33 
Acne, 65-67 
causes of, 65 
treatment, 66 
Air, amount breathed daily, 145 
"bouquet" of, 149 
chemical properties of, 149 
country, 149 
degree of moisture for house, 

155, 156 
impurities in, causes of, 152 
cumulative effects of, 152, 

153 
injurious effects of, 153 
indoor, 151 
infection of, 150 
overheated, injurious effects of, 

155 
pure, test of, 153 
town, 149 



Air, vitiation of, from combustion 
of lights, 152 
from respiration, 152 
from unhygienic conditions, 
152 
Alcohol, 127-135 
absorption of, 129 
anemia from use of, 131 
as a food, 127, 128 
cumulative effects of, 128 
narcotic effects of, 128 
physiologic action of, 127-130 
obesity caused by, 132 
on blood, 130 
on brain activity, 134, 135 
on digestion, 129 
on heart and blood-vessels, 

132 
on kidneys, 133 
on liver, 130 
on metabolism, 129 
on muscular system, 133 
on nervous system, 127, 

134, 193 
on oxidation, interference 

with, 131 
on self-control, 135 
rub, directions for, 35 
Alcoholic beverages, amount of 

alcohol in, 128 
Alimentary canal, 80 

microorganisms of, 220 
375 



376 



INDEX 



Ambition, excessive, 234, 244 
American men, improved phys- 
ique of, 287 
women, inferior physique of, 284 
Amino-acids, 94, 105 
Ammonia, aromatic spirits of, 

dose of, 218 
Amylase, 94 
Amylopsin, 94 
Anabolism, 99 
Anemia, causes of, 153 
Anger, injurious effects of, 245 
Animal food, 110 
Anxiety, injurious effects of, 246 
Arteries, description of, 139 
effect of cold on caliber of, 29, 
30, 140 
of muscular work on caliber 
of, 139 
Astigmatic chart, 208 
Astigmatism, correction of, 208 
injurious effects of uncorrected, 

208, 343 
test for, 208 
Athletic games and sports, 318, 
322, 370-373 
advantages derived from, 

318, 370-373 
and municipal govern- 
ments, 318 
basket-ball, 373 
benefits of, 319, 320 
best suited for women, 

321, 322 
croquet, 371 

ethical value of, 318-321 
hockey, 372 
lawn-tennis, 371 
Attitude, correct, at desk, 165 
in standing, 340 
faulty, injurious effects of, 164, 
342, 343 



Auto-infection, 170 
Auto-intoxication, 102 
Autosuggestion, 244 
Avocation, 198-200 

nature of, 198 

physiologic necessity for, 200 

Back, muscles of, 301, 302 

exercises for, 345, 346, 350, 
351 

function of, 301, 302 
Bacteria, action of sunlight on, 

151 
intestinal, 97 
role played by, 150 
Bacterial flora, 159, 220 
Baldness, causes of, 72 
treatment for, 72-74 
Basket-ball, 373 

Baths, action of, in health, 23, 58 
alkaline, 37 
cold, 29-33 

contraindications to, 31, 37 

heat loss in, 30 

physiologic effects of, 29 

reaction after, 30, 31 

tonic effect of, 29, 32, 33 

training for, 59, 60 
dip, 36 

contraindications to, 37 

duration of, 36 

temperature of, 36 
effects of, 23 
electric-light, 44-46 

directions for, 44, 46 

indications for its use, 45, 222 
foot, 39 

directions for, 39 

indications for, 39 

mustard, 183 
friction after, 31 
hot, 28, 29 



INDEX 



377 



Baths, hot, effects of, 28 

reaction after, 29 

restorative effects of, 29 
neutral, effects of, 29, 33 

temperature of, 29 
proper time for, 59 
Roman, 43 
Russian, 42 

contraindications for, 43 

indications for, 43 
saline, 37 

as cleansing agent, 38 
salt ablution, 41 

indications for its use, 41 
method of taking, 41 
shower, or rain douche, 38, 39 

cold, 38, 39 

directions for, 38 

effects of, 39 

hot, 38 

indications for, 39 

neutral, 38 

temperature of, 38 
sitz, 40 

duration of, 40 

indications for, 41 

temperature, 40 
sponge, 33, 34 
tub, 34, 36 

full, 36 

contraindications to, 36 

half, 35 

temperature of cold, 36 

of hot, 36 

of neutral, 36 
Turkish, 42-48 

contraindications for use of, 
44 

essential features of estab- 
lishment, 42 

indications for its use, 44 

loss of weight from, 46 



Baths, Turkish, method of pro- 
cedure, 42, 43 
necessity for cold water 
drinking, 42 
varieties of, 33 
Bathtub hose, fallacy in use of, 39 
Bedrooms, ventilation of, 156 
Bile, action of, 92 
Bladder, 179 
capacity of, 179 
frequency of emptying, 179 
location of, 179 
Blood, 142 
corpuscles of, 130, 142 
distribution of, 142 
functions of, 26, 130, 142 
length of time for passage 

through body, 141 
thinness of. See Anemia. 
vascular areas of, 27, 29 
Body, balance and carriage of, 
308, 322, 355 
common defects in, 309 
fatigue of, 193 
position of, 164, 165 
Boracic acid, solution of, 214 
Boxing, 353 

Brain and nervous system, 184- 
188 
blood supply, during sleep, 193 
development, of 189, 228-230, 

233, 241, 295, 320 
fatigue of, 185 

effect of body fatigue on, 
194, 221, 316, 317 
functions of, 184 
habit and automatism, 186 
master organ of body, 184 
physiology of, 187 
repair of, 185, 186 
rest of, 193, 197 
workers, average of life of, 233 



378 



INDEX 



Brains vigorous and strong bod- 
ies, 290, 292 

Breathing, art of, 167 
difficult, treatment of, 167 
exercises. See Respiratory. 
normal, 166 
types of, 167 

Bromid mixture, prescription for, 
218 

Bronchial tubes, 143 

Bronchitis, cause of, 150 

chronic, cure of, through exer- 
cise, 168, 169 

Capillaries, 139 
Carbohydrates, absorption of, in 
intestines, 95 
as protein protector, 100 
physiologically economic, 107 
Carriage, good, exercises for, 348, 

354 
Cataract, 215 

Character, formation of, 231, 238, 
241 
influenced by example, 228, 238 
mental poise, 234 
power of will, 242 
Cheese, indigestibility of, 112 
Chest, description of, 138 
development of, 344, 356, 362 
exercises for, 346, 349, 351, 

353, 354 
importance of good, 147 
flat, causes of, 165, 261, 265, 
309 
corrective exercises for, 165- 
168 
measurements minimum under 
arm, consistent with good 
health, 147 
relation between height, 
weight, and, 148 



Chest weights, exercises with, 353, 
354 
for arms, 354 
for chest expansion, 354 
for shoulders, 354 
rules for taking, 353 
Chilliness, cause of, 146 
Chlorids, 101 
Chyme, 90 

Circulation, maintenance of equi- 
librium, 143 
mechanics of, 138-142 
Circulatory apparatus, 139 

system, 137 
Clothing, measurements for, 164 
suspension of, from shoulders, 
164, 282 
Clouston, necessity for definite 

occupation, 248 
Clubs, literary, 199 

women's, benefits of, 199 
Clysters, colo-, 53 

directions for, 53, 54 
Cold, effects of prolonged appli- 
cation of, 30 
physiologic effects of, 29-32, 

139, 140 
reaction following, 30, 31 
condition unfavorable to, 31 
how promoted, 30, 31 
injurious effects following 
poor, 32 
tonic effects of, 32, 33 
Colds, causes of, 151, 153, 156 
common, 170 
contagiousness of, 163 
frequency of, 170 
reinfection from 170 
relation of, to influenza, 169 
to pneumonia, 169 
to tuberculosis 169 
treatment of, 145, 170, 171 



INDEX 



379 



Colds, treatment of, prescription 
for, 171 
quinin in, 171 
College life, advantages of, 232, 
233 
discipline of, 233 
Vassar, 235 
woman's medical, 235 
Coloclysters, directions for, 53, 54 
Colon, 96 

Color blindness, 215 
Complexion, 57, 58 
care of, 61-63 
good, 57, 58 
sallow, 64 
Conjunctivitis, causes of, 213 
granular. See Trachoma. 
symptoms of, 214 
treatment of, 214 
acute, 214 
chronic, 214 
Constipation 102, 

causes of, 103, 104, 344 
chronic, 104 
injurious effects of, 220 
appendicitis, 102 
autointoxication, 102 
hemorrhoids, 102 
uterine displacements, 
102 
treatment, 52-54, 103 
Corns, treatment, 79 

varieties, 78 
Corsets, 255, 256, 275 
abdominal, 269, 270 
crusade against, 259 
curved front, 261, 262 
directions for adjusting, 274 
effect on lung capacity, 261, 
262 
on muscles, 264-268 
on thorax, 260 



Corsets, history of, 257-259 
hygienic, 269 
influence on female body, 260- 

270 
injurious effects of, 260-269 
relation to abdominal and pel- 
vic disorders, 262-264 
straight front, 268, 269 
tight lacing and, 260, 261, 274 
wearing by young girls, 270- 

272 
what style is least injurious, 
272-274 
Cosmetics for the face, 63, 64 
Cough, function of, 169 
Country folks, outings by, 200 

recreations for, 199 
Crampton, Dr., and school ath- 
letics, 287 
Croquet, 371 

Dance, arm movements, 359 

combination hand and foot 
movements, 360 

figures of, with simple exer- 
cises, 357 

fundamental positions of hands 
and feet, 357 

simple exercises, using funda- 
mental positions, 359 
Dancing, 289, 326 

aim of, 354 

benefits of, 354-357 

esthetic and classic, 354-357 

requisites for, 354 

society, 355 
Dandruff, 70-72 

causes of, 70 

contagiousness of, 71 
Deafness, causes of, 163 

prevention of, 163 
Debility, signs of, 216 



380 



INDEX 



Desk, correct attitude at, 165 
Development, necessity for good, 
298, 311, 314 
symmetric, 292, 315 
Diaphragm, 141, 142, 144, 261 
relative importance of, 144, 
147, 262 
Diet, balanced ration, 115 
finical, 172 
importance of fats in, 107, 112 

of varied, 116 
in sedentary occupation, 113 
in tropics, 121 
maintenance, 109 
practical facts for guidance, 115 
regulation of, with reference to 

minimum expenditure, 122 
relation to various conditions, 
112 
brain workers, 113 
children, 113 
muscular work, 113 
sex, 113 

temperament, 113 
tuberculosis, 172 
Dietaries, balanced ration, 115 
in health, 66 
in tropics, 121 

practical facts for guidance, 115 
standard, 109 
Dietetics, defined, 109 
Digestion, defined, 80 
controlling factors in, 83 
mechanical, 87 
psychic aspect, 85 
tone, 87 
gastric, 89 

absorption of food, 92 
chemical changes, in, 98 
mechanics of, 90 
intestinal, 92 

absorption of food, 94 



Digestion, intestinal, bacteria, 97 

mechanics of, 96 
Digestive fluids, 92-94 
bile, action of, 92 
gastric juice, 89 
intestinal juice, 92 
pancreatic, 93 
saliva, 88 

succus entericus, 94 
system, 80 
tract, 80 
Discipline, 228, 229, 232 
Disinfectants, carbolic acid, 175 
formaldehyd, 174, 175 
sulphur, 174 
Disinfection after tuberculosis, 

directions for, 174, 175 
Douche, 46-48 
application of, mass, 47 
pressure, 47 
temperature, 47 
cold, contraindications to, 48 
long applications, 47, 48 
mechanical effects of, 47 
physician's prescription for, 

48 
physiologic effects of, 48 
fan, 47 

horizontal jet, 47 
neutral, indications for, 48 
rain, 38, 39 

directions for, 38 
effects of pressure in, 39 
rationale of, 47 
Scotch, 47 

temperature and its effects, 
47 
neutral, 48 
Dress and woman's physical 
deterioration, 252-282 
corsets, 257-275 
gymnastic, 336 



INDEX 



381 



Dress, history of woman's, 252- 
259 
French, 255-259 
Greek, 252-254 
mediaeval, 254-256 
renaissance, 256, 257 
Roman, 253, 254 
shoes, 275-277 
street, winter, 282 
Drudgery, joyless, 198 
Dust, its relation to disease, 149 

Ear, 162 

ache, treatment of, 164 
description of, 162 
douching, 56 
wax, 163 

removal of, 163 
Eczema, 65 
chronic, 65 
seborrheic, 71 

causes of, 72 

symptoms of, 71 

treatment, 73, 74 
Education and the health of 

girls, 234 
college, 232 

discipline, 232, 233, 320 
effect on home, 237 

on physical health, 234, 236 
higher, of women, 234-237 

President Eliot on, 235- 
237 
mental development, 228-232, 
320 

faculties, balancing of, 234 

habits, 186, 187 
moral sense, 230, 231 
physical, influence on health, 

310-316, 324 
religious instincts, 231 
self-control, 229 



Education, truthfulness, 228, 229 
Eggs, digestibility of, 110 
nutritive value of, 110 
Electric-light baths, 44, 46 

comparison of, with other 

heat procedures, 44 
description of cabinet', 44 
indications for use of, 45 
length of stay in, 44 
reduction of weight through, 

46 
symptoms of too prolonged 

stay in, 46 
treatment, finishing, 45 
Eliot, President, on higher edu- 
cation of women, 235-237 
Emotional nature, 230, 231 
Emotions, depressing, 246 
physical effects of, 246 
the natural, 226, 227, 230, 231 
violent, 243 
Employees, care of, 324, 324, 357 
Enemas, 53, 54 

injurious effect of daily, 54 
Energy, 99 

Environment, 237-240 
friends, 238 

harm done by bad, 238, 239 
literature, 239, 240 
toilet, 237, 238 
Enzymes, action of, 84 

defined, 84 
Erepsin, 94 
Eustachian tube, 162 
Exercise after eating, 316 
after fasting, 335 
and amusement, 357, 370 
benefits, of, 311 312, 313, 323- 

325 
effects of, on brain develop- 
ment, 291 
on character, 291, 320 



382 



INDEX 



Exercise, effects of, on heart and 
lungs, 295, 310 
on muscles and blood-ves- 
sels, 293, 294, 295, 312 
gradual training in, 312 
heart's need of, 310 
increase of red blood-cells 

through, 294 
length of time for, 334, 362 
outdoor, horseback riding, 328, 
368 
mountain climbing, 365 
rowing, 369, 370 
running, 341, 364 
swimming, 365-368 
walking, 362-364 
passive. See Massage. 
physiology and pathology of, 

292, 311, 312 
regularity in, 288, 335, 362 
rules for taking, 334-336 
Exercises, corrective, abdominal, 
346, 348, 350, 352 
alternate kneeling, 348 
arms, 351, 353, 354 
balancing, 349 
back, for muscles of, 346, 

350-352 
carriage, 348 
chest, 351-354 
for developing various re- 
gions of the body, 341- 
354 
for extending depth of, 349 
forward projection of, 346 
hips, 352 

legs, 347, 351, 352 
poise, 348 
respiratory, 345 
rope pulling, 351 
shoulder-blade, 345, 346 
spine, 347 



Exercises, corrective, squatting, 
347 
standing, correct attitude in, 

340 
swimming, 351 
thighs, 351 
trunk flexions, 352 

lateral, 349, 352 
waist, 349, 351 
exhaustion, recovery from, 293, 

294 
free, rules for taking, 343 
of endurance, 292, 293, 295 
of strength and skill, 292, 
293, 295 
Exhaustion, injurious results of, 
193, 194, 197, 221 
recovery from 294 
symptoms of, 194-196 
Eyes, 204-211 
care of, 212 
healthy, 209 
injuries to, 213 
interruption of work of, 209, 

210 
protection of, 211 
removal of foreign bodies from, 
213. See Visual apparatus. 
Eyestrain, 204 

general symptoms of, 209 
local symptoms of, 209 
mechanism of, 209 
prevention of, 210 

Face as index of health, 57 
cleansing of, 61 
dryness of skin of, 62 
lotions, 62 
massage of, 67 
powders, 63, 64 
protection of, 63 
steaming, 67 



INDEX 



383 



Face, use of cosmetics, 63 

of soap, 62 
Facial blemishes, 65-67 

eczema, 65 
causes of, 65 
general treatment, 66 

freckles, 64 

liver spots, 64 

pimples and acne, 65 
causes of, 65 
treatment of, 66 

sallow complexion, 64 * 
treatment, 66 

wrinkles, 67-69 
Far-sightedness, 207 
Fat, 107, 112 

as protector of protein, 100 
Fatigue, undue, 294 

causes of, 199, 303, 304 

danger signal, 193 

economic waste of, 194 

effect of brain, on body fatigue, 
316,317 

effect of, on nerve cells, 192 

mental symptoms of, 192 

muscular, 303, 304 

normal, 192 

recovery from, 294 

toxins of, 190-192, 203 

treatment, 222, 305 
Fear, 227 

forms of, 227 

physical effects of, 227, 244 

universality of, 227 
Feet, care, of, 78 

corns, treatment of, 79 

ingrowing nails, 78 

perspiration of, 78 

protection of, 276, 277 
Female form, relative proportion 
of, 296 

generative organs, 179 



Female generative organs, Fal- 
lopian tubes, 179 
function of, 179 
ovaries, 179 
physiology of, 179 
uterus, 180 

functions of, 180 
respiratory movements 
of, 180 
Fencing, 353 

Food, absorption of, from in- 
testines, 94 
from stomach, 92 
amount required, 104 
animal, 110 
breads, defective method of 

preparation, 120 
carbohydrates, 107 
physiologically economical, 

107 
potatoes, 111 
rice, 111 
wheat flour, 111 
chemical changes in, in stom- 
ach, 89 
classification of, 105 
digestibility of 110 
beef, 110 
buttermilk, 111 
chicken, 110 
eggs, 110 
koumiss, 111 
milk, 111 
mutton, 110 
pork, 110 
economics, 122 

relation to social welfare, 114 
fat, 107, 112 
heat value and digestibility, 

110 
indigestible combinations, 119 
influence of, on secretion, 98 



384 



INDEX 



Food, iron, 102 

mineral substances, 107 

preparation of, 119 

proteins, 105, 115 
foods rich in, 115 

values, 124-127 

variety of, 116 

vitamins, 108 
Food-stuffs, carbohydrates, 107 
as protein protectors, 100 

classification of, 105 

daily amount required, 66 

fats, 107, 112 

as protein protectors, 100 

mineral substances, 107 

proteins, 105 

as source of energy, 105 

salt, 101 

water, 100 
Foot, configuration of, 337, 338 

description of, in walking, 338- 
340 
Freckles, 64 
Friction, mechanical effects of, 

31, 306 
Friends, choice of, 238 

molding effects of, 238, 239 

requirements for, 239 



Gaches-Sarraute, Madame, hy- 
gienic corsets, 269 

Games as supplement to gym- 
nastics. See Athletic games 
and sports. 

Gastric juice, 89 

Golf, 372 

Greek costumes, 252-254 

Gymnasium in campaign against 
disease, 323-325 
Vassar College, 325 

Gymnasiums, 336, 337 



Gymnasiums against disease, 312, 
313, 323-325 
and factories, 324, 325, 357 
and women's colleges, 325 
Gymnastic dress, 336 
Gymnastics, benefits from, 314- 
316 
for symmetric development, 

315 
medical, 314 
physical examination for, 326, 

327 
practice of, 314 
versus athletics, 313 

Habit and automatism, 186 
Habits and disease, 244 

age limit for, 186, 187 

bad, 186 
Hair, 70-76 

brushing, 73 

care of, 72-74 

cutting of, 74 

dandruff, 70 

description of, 70, 71 

dressing, 74 

gray, 75 

causes of, 75 
treatment of, 75 

premature thinness of, 70 
treatment of, 72, 73 

scalp, dry, treatment of, 74 
massage of, 74 

seborrhic eczema, 71 

shampoo, 73 

treatment of, 73 
Hair-brush, 73, 74 

care of, 74 
Hancock, Dr., physical training 

for women, 286 
Hands, care of, 76, 77 

chapped, 76 



INDEX 



385 



Hands, nails, care of, 76 
cleansing of, 77 
infection from lack of clean- 
liness, 77 
Headache, 216-219 

causes of, 209, 216, 217, 221 
symptoms of, 217 
treatment of, 217-219 
varieties of, 217 
neuralgic, 217 
Health, good, and vacations, 201, 
202 
evidences of, 215 
Hearing, impairment of, causes 

of, 163 
Heart, description of, 139 
frequency of beat, 140 
functions of, 139 
location of, 139 
Heart's need of exercise, 310 
Heat, animal, 26 
dissipation of, 26 
physiologic effects of, 27 
production of, 26, 27, 303, 308 
Height, weight, and chest meas- 
urements, relative proportion 
of, 148, 297 
Hemorrhoids, 102 
Hereditary predispositions, 225 
Heredity, influence of, on health, 

224-226 
Hockey, 372 
Hormones, 89 
Horseback riding, 328 
Hot-water bottle, action of, 29 
Houses, degree of moisture of air 
of, 155 
disinfection of, after tubercu- 
losis, 174, 175 
effects of gloomy, 238 
temperature of, 155 
ventilation of, 151-155 
25 



Hydrotherapy denned, 23 

value of, 23. See Baths and 
Douches. 
Hygiene of mind, 224-251 
Hygrometer, 156 



Idleness as cause of nervous 
prostration, 223, 247 
Thomas on ill effects of, 248, 
249 
Industrial training of women, 

necessity for, 247 
Infectious diseases, 169-175 

bronchitis, 159, 160, 168, 169 
causes of, 149-151, 153, 169 
common colds, 159, 169-171 
influenza, 159, 169, 170 
pharyngitis, 151, 159, 160 
Influenza, 169 
cause of, 150, 159 
relation of, to pneumonia, 171 
to tuberculosis, 169, 173 
Ingrowing toe-nails, causes of, 78 

treatment of, 78 
Inhibition, 240-242 
importance of, 242 
training in, 241 
Insomnia, 196 
causes of, 194, 196, 220 
injurious effects of, 203, 219 
treatment of, 39, 204 
Intestinal bacteria, 97 
Invertase, 94 
Iron, 102 
Irrigations, vaginal, 54-56 



Katabolism, 99 

Kidneys, description of, 175 

diseases of, treatment of, 52 

function of, 175-179 



386 



INDEX 



Kidneys, function of, relation of, 

to skin and lungs, 176 
Knee-chest position, description 

of, 53 

Lactase, 94 

Lamp shades, 211, 212 

Larynx, 143 

Laughter, physiologic necessity 

for, 200, 201 
Life, prolongation of, 132, 313 
Lighting, artificial, 211, 212 

natural, 212 
Lipase, 94 
Literature, 239, 240 

molding influence on the mind, 
239 

taste for, formed in youth, 240 
Lungs, 143 

description of, 143 

frequency of diseases of, 137 

good development of, 137, 311 
exercises for, 165-168, 345, 
349, 353 

hygiene of, clothes in relation 
to, 164 

relation of, to good health, 146 

secretion of, 145 

ventilation of, 165-168 

vital capacity of, 148 

weakness of, causes of, 137 

Maltase, 94 
Massage defined, 304 
benefits of, 304-306 
mode of procedure, 307 
movements of, 306 

friction, 306 

grasping and pinching, 306 

striking, 307 

stroking, 307 

vibration, 307 



Massage, rise of temperature 
after, 308 
time for giving, 307 
Mastication, 82, 88 
Meats, digestibility of, 110 
nutritive properties, 110 
Medical examination blank, 330 
Menstruation, 181-183 
anomalies of, 183 
painful, 183 
profuse, 183 
' scanty, 183 
suppressed, 183 

treatment of, 182, 183 
hygiene of, 181 

normal, average duration of, 
181 
character of, 181 
cold baths during, 181, 182 
exercise during, 182 
premonitory symptoms of, 181 
Mental activity, attitude and 
bodily function of, 242 
depression, 231 

development, 189, 190, 228- 
232, 233,241 
and physical training, 290- 
292, 295, 315, 320 
disorders of adolescence, 231 
emotions, exhausting nature of, 

245-247 
faculties, balance of, 234 
habits, 186, 187 
hygiene, 224-247 

hurry, effect of, 190 
qualities, 228 
Metabolism, 98 
cumulative effects of impure 

air on, 153 
effect of nitrogenous diet on, 

99 
water and, 100 



INDEX 



387 



Microorganisms in intestinal 

canal, 97 
Migraine, treatment of, 218 
Milk, digestion of, 111 
Mind hygiene, relation of, to 
physical health, 224-251, 320 
subconscious, 238 
Mineral substances, 107 

Vittel, 51 
Moral sense, 230, 231 
Mothers as educators, 224 

exhausted, 197 
Mountain climbing, 365 
Mouth, care of, 82 
cleansing of, 82 
Muscular system, 298-304 

action of muscles of abdo- 
men, 300 
of back, 301 
coordination, 304 
development prevented by cor- 
sets, 260, 261, 264-268, 270, 
271 
energy, 303 
fatigue, 303 
heat production, 303 

Nasal catarrh, causes of, 159 

general treatment, 151 

local, 160, 161 

prevention of, 160 
douche, 161 

passages, obstruction of, 158 
sprays, 160 

prescriptions for, 161 
Nature's restoratives, 196-200 

recreation, 198, 200 

rest, 197 

sleep, 198, 202, 203 
Near-sightedness, causes of, 206, 

207 
correction of, 207 



Nervous breakdowns, prevention 
of, 197, 199, 201 
disorders, causes of, 216 
functional, 215, 223 
headache, 216-219 
neurasthenia, 219 
system as balance of power, 
184 
brain as master organ of 
body, 184 
function of, 184 
physiology of, 187 
cerebrospinal nerves, 187 
spinal cord, 187 
sympathetic, 188 
Nervousness, 196 
causes of, 196 
treatment of, 305 
Neurasthenia, 219-223 
causes of, 219, 220 
rational treatment, 221-223, 

305 
symptoms of, 221 
Nitrogenous waste products,. 106 
Nose, care of, 157 
functions of, 157 

Obesity, causes of, 132, 298 

treatment of, 45, 52, 298, 344 
Occupation, definite, a physical 
necessity, 247 
Clouston on, 248. See Voca- 
tion. 
sedentary, 165 
Optical defects and their correc- 
tion, 206-209 
astigmatism, 208 
hyperopia or far-sightedness, 

207 
myopia or near-sightedness, 
206 
causes of, 207, 209 



388 



INDEX 



Optical defects, myopia, treat- 
ment of, 207 
presbyopia or loss of ac- 
commodation, 207 
Out-door exercise, 362 

daily length of time for, 362 
Overwork, 193, 194 
danger signals, 193 
signs of, 194-196 
stimulants in, 193 
worry and, 195 
Overworked class, rest treatment 

for, 222, 223 
Oxygen, importance of, 145 

Palate, soft, 158 
Pancreatic juice, 93 

rennin, 93 
Perspiration, daily amount of, 26 
effect of, on tone of skin, 29 
rate of increase in hot baths, 
28 
Pharynx. See Throat. 
Physical efficiency, 11 
an exact science, 13 
marks for, 13, 317 
reflex effect of group impair- 
ment on organism, 19 
standardized percentage 

table, 14, 328 
statistical study, 15 
wisdom of, 11 
exercise, rules for, 334-336 
measurements, record for, 327, 

334 
status of women of today, 19 
training among the ancients, 
283, 284, 289 
before twelve years of age, 

333 
dancing, 289, 326 
examinations for, 326, 327 



Physical training for invalids, 334 
improved physique from, 

286, 325 
influence on life and health, 

290 
key to health and beauty, 

283-322 
of girls, 286, 289, 321, 333 
of Japanese women, 286 
report of Royal Commission 
on, 288 
Physique, good, through physical 
training, 333 
improved, of American women, 
287 
of school children, 287 
Play, adult, 288 
Pleasure seeking as the object 

of life, 189, 247, 249 
Pneumonia following influenza, 
169 
mortality from, 171 
Potatoes, 111 
Prosecretin, 92 
Proteins, 105 
Pulley weights, exercises with. 

See Chest weights. 
Pulse, frequency of, 140 

Reading, distance of book from 
eyes, 165 
fine type, 212 

hygienic precautions, 212, 213 
length of line, 212 
position of reader in, 212 

Recreation, necessity for, 220 

Religion, 232 

Religious instincts, 231, 232 

Rennin, pancreatic, 93 

Respiration during sleep, 166 
forced, benefits of, 165, 166 
impediments to normal, 164 



INDEX 



389 



Respiration, mechanics of, 138, 
141 
normal, relation to body heat, 

146 
types of, 167 
costal, 167 
diaphragmatic, 167 
thoracic, 167 
vitiation of air in, 152 
Respiratory exercises, 165-168, 
345 
beneficial results of, 311 
best time for, 166, 167 
dress for, 166 

frequency of, practice of, 166 
system, 137-157 
air cells, 143 
bronchial tubes, 144 
expiration, 143 
inspiration, 143 
forced, 144 

function of abdominal 
muscles, 146, 344 
larynx, 143 
lungs, 143 

hygiene of, and relation to 

general health, 146 
secretion of, 145 
vital capacity of, 144 
thorax, 138 
trachea, 143 
Rest, 197 

days of, 200, 201 
proper way to, 197, 198 
regularity of, 197 
Rice, 111 
Roman baths, 43 
Rowing, 369 
Running, 293, 364 
age limit for, 365 
benefits of, 310 
rules for, 341 



Saliva, 88 
Salt, common, 101 
normal, solution, 53 
sea, 41 
Sargent, Dr. Dudley A., 284, 285, 

287, 317, 321 
Scalp, massage of, 74 
Sebaceous glands, function of, 25 

infection through, 25 
Secretin, 92 
Self-control, 229, 230 
difficulty of, 229 
standards aimed at, 229 
training in, 230 
Semiconstipation, 102 
Senility, causes of, 133 
Sewing, hygienic precautions in, 

212, 213 
Shoe, 275-277 

compression of foot by, 275 
flat heels, 276 
French heels, 277 

awkward gait due to, 277, 

339 
deformities caused by, 277 
injurious effects of, 277 
proper length of, 276 
soles of, 276 
Shoulder-blade exercises, 345 
Shoulders, round, and inequality 
of height of, 342 
causes of, 342 

corrective exercises for, 345, 
346 
Sims' position described, 53 
Skin, absorption through, 28 
care of, 57-69 
description of, 24, 25 
diseases, acne, 65 
eczema, 65 
treatment of, 66 
functions of, 25 



390 



INDEX 



Skin, functions of, respiration 
through, 28 
role played in maintaining 
body temperature, 26 
sebaceous glands, 25 
sweat glands, 25 

perspiration, daily amount 
of, 26 
temperature of, 31 
tone of, 25 
Skirt, walking, 202-204 
Sleep, 202-204 
amount necessary, 196, 203 
dreamless, 204 
favorable conditions for, 204 
habits of, 198, 203 
physiologic necessity for, 185, 
192, 193, 203 
Sleepiness, causes of, 203 
Soap, 58 
castile, 61 
sand, 61 

tincture of green, 73 
Social instincts, 226 
at school age, 226 
right training of, 241 
Sore throat, prevention of, 160 

treatment of, 160, 161 
Spinal cord center of reflex acts, 
187 
curvature, 309 

causes of, 164, 342, 343 
general treatment for, 343 
Spine, muscles of, exercises for 

strengthening, 347 
Spirometer, 148 
Sponge as article of toilet, 33 
Spray apparatus, description of, 
160 
liquids for, 161 
oil, formula for, 161 
Standing, common defects in, 340 



Standing, correct attitude in, 340 
Steapsin, 94 

Stocking supporters, 278 
Stockings, evils of short, 277 
Stomach, chemical changes in 
food in, 89 

description of, 89 

location of, 89 
Street dress, winter, 282 
Styes, treatment of, 215 
Success defined, 249 

elements of, 249 

lack of, 250 

mental condition and, 250 

psychology of, 249-251 
Succus entericus, 94 
Sugar, absorption of, in in- 
testines, 95 
Sunlight, action on respiration, 
149 
on tubercle bacillus, 151 
Swimming, 365-368 

contraindications to, 368 

exercises, 351 

pool, temperature of, 326 

rules for, 366-368 
Swift, Prof., theories regarding 
children, 228, 233 
fighting among boys, 
233 

Tea, effect of, on digestion, 119 

proper way to make, 120 
Teeth, 82 

care of, 82, 83 

cleansing of, 83 

tartar, 83 

tooth-brush, 83 
Temperament, 225, 226 

arthritic, 226 

nervous, 225 

temptations of, 226 



INDEX 



391 



Temperament, phlegmatic, 226 
Temperature for house, 155 
normal body, 27, 28 
how maintained, 28 
mouth, 28 
rectum, 28 
surface, 31 
Thomas, Prof., on effect of idle- 
ness, 248 
on necessity of definite vo- 
cation, 249 
Throat or pharynx, 137 
bacterial flora in, 151 
description of, 158 
diseases of, causes of, 158 
effect of lowered vitality on, 

151 
importance of healthy condi- 
tion of, 151, 159 
pillars of, 158 
sore, prevention of, 160 
treatment of, 160, 161 
Toe-nails, ingrowing, 78 
Tonsils, chronic enlargement of, 

159 
Trachea, 143 
Trachoma, 214, 215 
Tropics, dietary in, 121 
Trypsin, 93 
Tubercle bacillus, 150 

destruction of, 174 
Tuberculosis, causes of, 137, 150, 
309 
diet in, 172 

disinfection after, 174, 175 
expectoration in, 150, 173 
infection in, 150, 173 

source of, 173 
mortality in, 137 
prevention of, 171-174 
Turkish baths, 42-44 
cold plunge, 43 



Turkish baths, cold plunge, con- 
traindications to, 31, 37 

contraindications for their 
use, 44 

essential features of estab- 
lishment, 42 

harmful results of too pro- 
longed stay in, 42 

indications for their use, 44 

methods of procedure, 42-44 

necessity for cold water 
drinking, 42 

physician's prescription for, 
43 

shampoo, 43 

steam room, 43 

contraindications for 
use of, 43 

Underclothing, combination 
suits, 280 
winter, 278-281 

equestrian tights, 280 
essential qualities of, 278 
Urea, 106 
Uric acid, 106 

treatment of, 45 
Urinary excretory apparatus, 179 
Urine, 178 
daily amount of, 178 
secretion of, 176 
specific gravity of, 178 
toxicity of, 178, 179 
urea, 178 
uric acid, 178 
value of study of, 178 
Uv ola, relaxation of, 158 

Vacations and health, 201, 202 
resorts, requisites for, 202 
rules for, 202 

Vaginal irrigations, 54-56 



392 



INDEX 



Vaginal irrigations, directions 
for, 54, 55 
indications for use of, 55 
Vassar College, 235 

gymnasium, 325-328 
Veils, 210 

Ventilation, 151-155 
method of, 154 
necessity for indoor, 151 

hourly amount of fresh air 
needed, 151 
of bedclothes, 157 
of bedrooms, 156 
of houses, 151-155 
of lungs, 165-168 
Vision, defective. See Optical 

defects. 
Visual apparatus, 205, 206 

accommodation, mechanism 

of, 206 
conjunctiva, 205 
description of, 205 
eyeball, 205 
eyelashes, 205 
eyelids, 205 

image, formation of, 206 
iris, 205 

function of, 206 
lachrymal glands, 205 
tears, function of, 205 
Vitamins, 108 

Vocation, physiologic necessity 
for, 247 
Clouston on, 248 
Thomas on, 248, 249 

Waist exercises, 349, 351, 356 
Walk, listless, bad effects of, 364 
Walking, clothing for, 282, 363 
effect of speed in, 293 
on blood-vessels and mus- 
cles, 363 



Walking; effect of, on heart and 
lungs, 362 
position of feet in, 341 
skirt, 281 
proper length of, 281 
Walks, rules for long, 364 
Wash cloths, care of, 61 

danger of infection from, 
61 
Waste products, nitrogenous, 106 
Water and metabolism, 100 
internal use of, 48-52 

action on digestion, 50 

on heart and blood, 50 
at meals, 50, 51 
boiled, 49 

classification of tempera- 
ture of, 28 
cold, contraindications to, 

52 
infection, vehicle for, 49 
mineral, 118 
physiologic effects of, 28 
therapeutic indications 

for, 50-52 
time required for its ab- 
sorption, 50 
Weichardt, Dr., experiments on 

guinea-pigs, 191 
Weights for women, table of, 
relation between height and, 
296, 297 
Weisse, Dr., table of weights, etc., 

296, 297 
Will, education of, 241-245 
influence of, on conduct, 241, 

242 
inhibition, 240-242 
obsessions, overcoming of, 241 
power of, and strong muscles, 

291, 292 
training of, 241 



INDEX 



393 



Women, American, cause of in- 
ferior physique of, 284-286 
average height of, 298 
higher education of, 234-237 
in business activities, 237, 

248 
Japanese, 286 

non-occupation of, 248, 249 
noted sovereigns as mothers, 

247 
physical status, 19 
Woolen undergarments, 279, 280 



Work, hygiene of, 188 

number of hours allotted to, 
194 

philosophy of, 188 

physiologic necessity for, 189 
Worry, 195, 196 

denned, 245 

results of, 246 
Wrinkles, 67-69 

causes of, 67, 68 

results of, 68, 69 
Writing, use of typewriter, 165 



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By Percy Goldthwait Stiles, 
Harvard University. 229 pages, 
illustrated. Price: $1.2 5, postage free. 




W. B. Saunders Company 



Aikens' Home Nurse's Handbook 

You will find the entire realm 
of home nursing very com- 
pletely presented here. The 
author knows, from long active 
experience, just how to meet 
emergencies, how to improvise, 
how to manage. She shows you 
what to have ready in times of 
(illustration muck reduced) sickness, how to make the bed, 

how to care for, feed, and bathe the patient, how to give 
home treatments, etc. Home care is dealt with exhaustively. 

By Charlotte A. Aikens, formerly Director of Sibley Memorial 
Hospital. 276 pages, illustrated. Price: $1.50, postage free. 




LIFTING PATIENT IN BED 



Hoxie's and LaptacTs Medicine 

The purpose of this book is 
to provide enough informa- 
tion about the nature, cause, 
and cure of disease to enable you 
to carry out the doctor's orders 
intelligently, to. know when home 
treatment is sufficient, and" how 
and what to apply, to recognize 
when professional advice should putting drops in the eye 

, 1 ., 1 i i (Illustration much reduced) 

be sought, and how to render 

first aid in emergencies. It is just the manual you need 
in caring for illness and preventing its spread in your home. 
By George Howard Hoxie, M. D., and Pearl L. Laptad. Second 
Edition. 351 pages, illustrated. Price: $1.50, postage free. 




Military Hygiene 




Keefer's Military Hygiene 

This subject is one of the many 
which the present crisis has forced 
upon public attention. Military 
sanitation is a very important 
phase of national preparedness. Dr. 
Keefer is in every way equipped to teach 
the subject, and he has, moreover, in- 
corporated the views of the ablest in- 
vestigators in the discussions. He gives you chapters on the 
hygiene and sanitation of every side of military life 

By Lieut. -Col. Frank R. Keefer, A. M., M. D., United States 
Military Academy, West Point. 305 pages, illustrated. 

Price: $1.50, postage free. 

Kaupp on Poultry Culture 

This work gives you the breeds and varieties of poul- 
try, problems of mating, breeding, hygiene, equip- 
ment, ridding stock of vermin, internal parasites, and 
other diseases; the feeding problem and food-stuff s. com- 
pounding rations, fattening, broilers, dress- 
ing, packing, selling, care of eggs, incuba- 
tors, brooding, marketing eggs, handling 
feathers, value of droppings as fertilizer, 
caponizing and spaying, preparing birds 
for showroom, and construction of poul- 
try-house equipment. 
By B. F. Kaupp, M.S., D. V. M., North Carolina Experiment 
Station. 418 pages, 197 illustrations. Price: $2.00, postage free. 




W . B. Saunders Company 



Winslow's Prevention of Disease 



There are 800,000 deaths every year 
in this country from preventable dis- 
ease. The greatest — and, in fact, the 
only — safeguard against the spread of 
disease is a helpful knowledge of its causes 
by the layman. No amount of watchful- 
ness can save you unless you know how, 
when, and where to be careful. Dr. Win- 
slow's book begins with the care of the 
! child shortly after birth, and follows every 
step of its development throughout life. 

ADENOIDS ±0 

Its contents cover every disease that flesh 
is heir to, from infancy to old age. It is a book that aims to 
keep you well and prolong your life. 

By Kenelm Winslow, M. D., formerly at Harvard University. 
348 pages, illustrated. Price: $1.75, postage free. 




Morrow's Immediate Care of Injured 

Dr. Morrow's book tells you just what to do in any 
emergency, and it is illustrated in such a practical 
way that the idea is caught at once. You get first a 
brief outline of the anatomy and physiology of the human 
body, essential to rendering intelligent assistance in cases of 
injury and sickness. There follow chapters on bandaging, 
dressings, practical remedies, when and how to apply them, 
and the best way to treat every emergency condition. 

By Albert S. Morrow, M. D., New York Polyclinic. 360 pages, 
242 illustrations. Second Edition. Price: $2.50, postage free. 



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